George N Gwako1, Moses M Obimbo1,2, Peter B Gichangi2,3, John Kinuthia1,4, Onesmus W Gachuno1, Fredrick Were5. 1. Department of Obstetrics & Gynecology, University of Nairobi, Nairobi, Kenya. 2. Department of Human Anatomy, University of Nairobi, Nairobi, Kenya. 3. Deputy Vice-Chancellor Academic, Research and Extension, Technical University of Mombasa, Mombasa, Kenya. 4. Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya. 5. Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Abstract
OBJECTIVE: To evaluate the association between obstetric and medical risk factors and stillbirths in a Kenyan set-up. METHODS: A case-control study was conducted in four hospitals between August 2018 and April 2019. Two hundred and fourteen women with stillbirths and 428 with live births at more than >28 weeks of gestation were enrolled. Data collection was via interviews and abstraction from medical records. Outcome variables were stillbirth and live birth; exposure variables were sociodemographic characteristics, and medical and obstetric factors. The two-sample t test and χ2 test were used to compare continuous and categorical variables respectively. The association between the exposure and outcome variable was done using logistic regression. A P value less than 0.05 was considered statistically significant. RESULTS: Stillbirth was associated with pre-eclampsia without severe features (odds ratio [OR] 9.1, 95% confidence interval [CI] 2.6-32.5), pre-eclampsia with severe features (OR 7.4, 95% CI 2.4-22.8); eclampsia (OR 9.2, 95% CI 2.6-32.5), placenta previa (OR 8.6 95% CI 2.8-25.9), placental abruption (OR 6.9 95% CI 2.2-21.3), preterm delivery(OR 9.5, 95% CI 5.7-16), and gestational diabetes mellitus, (OR 11.5, 95% CI 2.5-52.6). Stillbirth was not associated with multiparity, anemia, and HIV. CONCLUSION: Proper antepartum care and surveillance to identify and manage medical and obstetric conditions with the potential to cause stillbirth are recommended.
OBJECTIVE: To evaluate the association between obstetric and medical risk factors and stillbirths in a Kenyan set-up. METHODS: A case-control study was conducted in four hospitals between August 2018 and April 2019. Two hundred and fourteen women with stillbirths and 428 with live births at more than >28 weeks of gestation were enrolled. Data collection was via interviews and abstraction from medical records. Outcome variables were stillbirth and live birth; exposure variables were sociodemographic characteristics, and medical and obstetric factors. The two-sample t test and χ2 test were used to compare continuous and categorical variables respectively. The association between the exposure and outcome variable was done using logistic regression. A P value less than 0.05 was considered statistically significant. RESULTS: Stillbirth was associated with pre-eclampsia without severe features (odds ratio [OR] 9.1, 95% confidence interval [CI] 2.6-32.5), pre-eclampsia with severe features (OR 7.4, 95% CI 2.4-22.8); eclampsia (OR 9.2, 95% CI 2.6-32.5), placenta previa (OR 8.6 95% CI 2.8-25.9), placental abruption (OR 6.9 95% CI 2.2-21.3), preterm delivery(OR 9.5, 95% CI 5.7-16), and gestational diabetes mellitus, (OR 11.5, 95% CI 2.5-52.6). Stillbirth was not associated with multiparity, anemia, and HIV. CONCLUSION: Proper antepartum care and surveillance to identify and manage medical and obstetric conditions with the potential to cause stillbirth are recommended.
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