Stillbirths in Primary Level Hospitals in Sunyani, Ghana: A Retrospective Data Analysis
Paulina C. Appiah *
Municipal Health Directorate, Ghana Health Service, Sunyani, Ghana.
Kingsley Arhin-Wiredu
Municipal Health Directorate, Ghana Health Service, Sunyani, Ghana.
Michael R. Adjei
Techiman North District Health Directorate, Ghana Health Service, Tuobodom, Ghana.
Charles L. Noora
School of Public Health, University of Ghana, Legon, Ghana.
Janet V. Baafi
Fiapre Health Centre, Sunyani West District Health Directorate, Fiapre, Ghana.
Timothy S. Letsa
Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana.
Alfred Edwin Yawson
Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Aims: To determine prevalence and factors influencing stillbirth among deliveries.
Study Design: A facility-based cross-sectional analytical study.
Place and Duration of Study: Sunyani Municipal and Seventh Day Adventist (SDA) Hospitals in Bono Region, Ghana from January, 2014 and December, 2015.
Methodology: Two thousand and twelve deliveries were analyzed. Outcome variable was stillbirth, explanatory variables were the sociodemographic, obstetric and clinical characteristics. Logistic regression (bivariate and multivariate) analysis reporting odds ratio at 95% confidence interval were calculated to identify factors associated with stillbirth.
Results Stillbirth rate was 15/1000 births. Mean age of mothers was 28.2 ±5.9 years and majority (75.1%) were aged 20-34 years. Prevalence of stillbirth was higher among women with no formal education (2.1%). Odds of stillbirth decreased with additional antenatal care (ANC) visits; 2-3times ANC visits (AOR=0.16, 95% CI:0.06 - 0.48), ANC 4+ times (AOR=0.017, 95% CI: 0.006 - 0.052). Women who received 3+ doses of intermittent prophylactic treatment (IPT) for malaria had 68% reduction in odds of stillbirth compared with those who had one (AOR=0.32, 95% CI: 0.009-0.103). Women with haemoglobin greater than 11.0 g/dl were more than 70% less likely of stillbirth outcome (AOR = 0.29, 95% CI: 0.11-0.73).
Conclusion: High number of ANC visits, optimal maternal haemoglobin (>11.0 g/dl) and 3+ IPT are associated with lower risk of stillbirth among deliveries. Premium should be placed on quality of ANC to suit the specific needs of pregnant women whiles encouraging more visits.
Keywords: Sunyani, primary level hospital, stillbirth, antenatal care