Risk Factors for Stillbirth and Early Neonatal Mortality: A Case-Control Study in Tertiary Hospitals in Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Eskinder Kebede Weldetensaye ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
Maternal Education ◽  
Case Control Study ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Mortality ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background: Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, perinatal mortality continues to be a major obstacle. The nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births.Methods: This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital (TAH) and Gandhi Memorial Hospital (GMH). All women who had a stillbirth or early neonatal mortality during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital was approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on potential risk factors were retrieved from medical records including health passports, delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher's exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal mortality.Results: During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. During the study period, records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal mortality were low maternal education (aOR 1.747, 95%CI 1.098-2.780), high parity (aOR 1.114, 95%CI .058- 2.484), previous stillbirth (aOR 9.447, 95%CI 6.245-14.289), previous preterm birth (aOR 3.620, 95%CI 2.363-5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228-3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523-7.031).Conclusion: Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services, particularly for women who have a history of obstetric complications identified as risk factors. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.

scholarly journals Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in Addis Ababa, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eskinder Kebede ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Death ◽  
Maternal Education ◽  
Case Control Study ◽  
Addis Ababa ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Death ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, the nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births. Methods This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital and Gandhi Memorial Hospital. All women who had a stillbirth or early neonatal death (i.e. death within 7 days) during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital were approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on risk factors were retrieved from medical records including delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher’s exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal death. Results During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. Records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were 30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal death were low maternal education (aOR 1.747, 95%CI 1.098–2.780), previous stillbirth (aOR 9.447, 95%CI 6.245–14.289), previous preterm birth (aOR 3.620, 95%CI 2.363–5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228–3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523–7.031). Conclusion Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.

scholarly journals Risk factors for stillbirth and early neonatal death: A case-control study in tertiary hospitals in Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Eskinder Kebede Weldetensaye ◽  
Melani Kekulawala
Keyword(s):  
Risk Factors ◽  
Neonatal Death ◽  
Maternal Education ◽  
Case Control Study ◽  
Addis Ababa ◽  
Case Control ◽  
Categorical Variables ◽  
Early Neonatal Death ◽  
Tertiary Hospitals ◽  
Control Study

Abstract Background: Globally, Ethiopia is ranked seventh in the absolute number of stillbirths. Attempts to decrease this number have been obstructed by an inadequate understanding of the risk factors leading to stillbirth and early neonatal death in Ethiopia. This study was conducted in two tertiary hospitals in Addis Ababa, Ethiopia, to identify the risk factors for stillbirth and neonatal death in this setting.Methods: This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital (TAH) and Gandhi Memorial Hospital (GMH). All enrolled women who had a stillbirth or early neonatal death during this period were included as cases and a random sample of women delivering at the hospital was selected to enroll as controls for a 2:1 ratio of controls to cases. Data on potential risk factors were retrieved from medical records including health passports, delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher’s exact test) for quantitative and categorical variables, respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal death.Results: During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. During the study period, hospital records indicated that the estimated stillbirth and neonatal death rates were 30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal death were maternal education (aOR 1.747, 95%CI 1.098-2.780), parity (aOR 1.114, 95%CI .058- 2.484), previous stillbirth (aOR 9.447, 95%CI 6.245-14.289), previous preterm birth (aOR 3.620, 95%CI 2.363-5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228-3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523-7.031).Conclusion: Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services, particularly for women who have a history of obstetric complications identified as risk factors.

Risk factors for perinatal mortality: a case control study from Thiruvananthapuram, Kerala, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2452 ◽  
Author(s):  
Mayadevi Brahmanandan ◽  
Lekshmi Murukesan ◽  
Bindu Nambisan ◽  
Shaila Salmabeevi
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Case Control Study ◽  
Gestational Hypertension ◽  
Significant Risk ◽  
Case Control ◽  
Maternal Risk ◽  
Perinatal Mortality Rate ◽  
Control Study

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.

scholarly journals Maternal Mortality and Contributing Risk Factors

2016 ◽  
Author(s):  
Abi Bazar
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Health Care Quality ◽  
Maternal Education ◽  
Case Control Study ◽  
Case Control ◽  
Care Quality ◽  
Control Group ◽  
Risks Factors ◽  
Control Study

Objectives: Maternal mortality is one indicator to assess a nation’s health care quality. This research was conducted to determine the determinant risk factors for maternal mortality. Methods: A retrospective case control study at Dr. Mohammad Hoesin General Hospital for 5 years, with 200 samples consists of 50 cases of maternal mortality and 150 physiological labor cases as control group. Results: For 5 years, there was 109 cases of maternal mortaliy. Of the 50 samples of maternal mortality cases, the most common cause were preeclampsia/eclampsia (50%), followed by hemorrhage (28%). The risk factors were categorized as distant, intermediate, and outcome factors, as stated by McCarthy et al. On bivariate analysis, we found the significance on maternal education and husband’s occupation (distant factors), residence, referral status, numbers of ANC visits, first attendant, labor facility and history of prior medical history (intermediate factors), and also modes of delivery and complications (outcome factors). On the multivariate analysis to determine the most contributing risks factors for maternal mortality, it was found that maternal education and residence were the most influencing factors for maternal mortality (OR 5.74 and 4.65 respectively; p=0.001). Conclusions: The most contributing risks factors for maternal mortality were maternal education and residence. [Indones J Obstet Gynecol 2012; 36-1:8-13] Keywords: case control study, maternal mortality, risk factors.

scholarly journals Risk factors for major external structural birth defects among children in Kiambu County, Kenya: a case-control study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 59
Author(s):  
George N. Agot ◽  
Marshal M. Mweu ◽  
Joseph K. Wang'ombe
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Case Control Study ◽  
Case Control ◽  
Categorical Variables ◽  
Surveillance Systems ◽  
Continuous Variables ◽  
Reproductive Health Services ◽  
Multifactorial Inheritance ◽  
Control Study

Background: Although major external structural birth defects continue to occur globally, the greatest burden is shouldered by resource-constrained countries with no surveillance systems. To our knowledge, many studies have been published on risk factors for major external structural birth defects, however, limited studies have been published in developing countries. The objective of this study was to identify risk factors for major external structural birth defects among children in Kiambu County, Kenya. Methods: A hospital-based case-control study was used to identify the risk factors for major external structural birth defects. A structured questionnaire was used to gather information retrospectively on maternal exposure to environmental teratogens, multifactorial inheritance, and sociodemographic-environmental factors during the study participants' last pregnancies.  Descriptive analyses (means, standard deviations, medians, and ranges) were used to summarize continuous variables, whereas categorical variables were summarized as proportions and percentages in frequency tables. Afterward, logistic regression analyses were conducted to estimate the effects of the predictors on the odds of major external structural birth defects in the country. Results: Women who conceived when residing in Ruiru sub-county (adjusted odds ratio [aOR]: 5.28; 95% CI: 1.68-16.58; P<0.01), and Thika sub-county (aOR: 0.27; 95% CI; 0.076-0.95; P =0.04); and preceding siblings with history of birth defects (aOR: 7.65; 95% CI; 1.46-40.01; P =0.02) were identified as the significant predictors of major external structural birth defects in the county. Conclusions: These findings pointed to MESBDs of genetic, multifactorial inheritance, and sociodemographic-environmental etiology. Thus, we recommend regional defect-specific surveillance programs, public health preventive measures, and treatment strategies to understand the epidemiology and economic burden of these defects in Kenya. We specifically recommend the integration of clinical genetic services with routine reproductive health services because of potential maternal genetic predisposition in the region.

Searching for socioeconomic risk factors in perinatal mortality in Kuwait: a case control study

2000 ◽  
Vol 51 (4) ◽  
pp. 539-550 ◽  
Author(s):  
Nasra M Shah ◽  
Makhdoom A Shah ◽  
Abdul Aziz Khalaf ◽  
Mustafa Mohammad Mustafa ◽  
Ali Al-Sayed
Keyword(s):  
Risk Factors ◽  
Perinatal Mortality ◽  
Case Control Study ◽  
Case Control ◽  
Socioeconomic Risk ◽  
Control Study ◽  
Socioeconomic Risk Factors

scholarly journals FAKTOR RISIKO KEJADIAN PREEKLAMSIA DI RSIA SITI KHADIJAH GORONTALO

2019 ◽  
Vol 8 (2) ◽  
pp. 150
Author(s):  
Zulfikar Ahmad ◽  
Siti Surya Indah Nurdin
Keyword(s):  
Risk Factors ◽  
Maternal Education ◽  
Case Control Study ◽  
Neonatal Morbidity ◽  
Total Sample ◽  
Case Control ◽  
Influential Factor ◽  
History Of ◽  
Child Hospital ◽  
Control Study

Preeclampsia is one of the major causes of maternal, fetal and neonatal morbidity and mortality. The research aimed at investigating the risk factor of the preeclampsia incident in Mother and Child Hospital Siti Khadijah Gorontalo. The research used the case control study design. Case samples are mothers who suffer from preeclampsia, while control samples are mothers who did not experience preeclampsia during pregnancy. The total sample of 78 people The results of this study indicate that risk factors for the incidence of preeclampsia include socioeconomic status (OR = 3,976, CI%: 1,399 - 11,301), maternal education (OR = 4,396, 95% CI: 1,518 - 12,374), and history preeclampsia (OR = 8,441, 95% CI: 1,469 - 48,501). Maternal occupation, maternal age, history of hypertension, and parity are not risk factors for the incidence of preeclampsia. The most influential factor on the incidence of preeclampsia is the history of preeclampsia.Preeklampsia merupakan salah satu penyebab morbiditas dan mortalitas pada ibu, janin dan neonatal. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan kejadian preeklampsia di RSIA Siti Khadijah Gorontalo. Penelitian ini menggunakan desain Case Control Study. Populasi penelitian adalah semua ibu melahirkan selama tahun 2019 di RSIA Siti Khadijah Gorontalo. Sampel kasus merupakan ibu yang menderita preklamsia, sedangkan sampel kontrol merupakan ibu yang tidak mengalami preeklampsia saat hamil. Jumlah sampel sebanyak 78 orang Hasil penelitian ini menunjukkan bahwa faktor risiko terhadap kejadian preeklampsia meliputi status sosial ekonomi (OR = 3,976, CI %: 1,399 – 11,301), pendidikan ibu (OR = 4,396, CI 95% : 1,518 – 12,374), dan riwayat preeklampsia (OR = 8,441, CI 95%: 1,469 – 48,501). Pekerjaan ibu, usia ibu, riwayat hipertensi, dan paritas bukan faktor risiko terhadap kejadian preeklampsia. Faktor yang paling berpengaruh terhadap kejadian preeklampsia adalah riwayat preeklampsia.

scholarly journals A case control study of modifiable risk factors of low birth weight among full term babies at Omdurman maternity hospital, Khartoum, Sudan 2019

2021 ◽  
Author(s):  
Ethar Abdullah
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Maternal Education ◽  
Case Control Study ◽  
Newborn Infants ◽  
Case Control ◽  
Full Term ◽  
Smoking During Pregnancy ◽  
Control Study

Abstract Low birth weight (delivery of an infant with less than 2500 grams) is owed to two main causes, either IUGR or pre-term delivery. It makes the newborn susceptible to many health issues from birth and through the adulthood life. Whoever IUGR is the leading cause of LBW in developing countries, and hence it is more reliable here in Sudan to study the risk factors that lead to it which are whoever mostly modifiable. This is a hospital based unmatched case-control study. A total of 134 (67 cases and 67 controls) mothers and their full-term newborn infants were included in the study. The participants were interviewed with a questionnaire and anthropometric measurements were obtained at the end of the interview. The data was analyzed using SPSS and Odd ratios of the risk factors were calculated. The main risk factors that found to influence the birth weight of our study participants were lack of maternal education, rural place of residence, bleeding during pregnancy, high blood pressure during pregnancy, inadequate spacing, lack of ANC follow up, not having iron supplementation and exposure to passive smoking during pregnancy.

scholarly journals Risk Factors of Anaemia among Children under Five Years in the Hohoe Municipality, Ghana: A Case Control Study

Anemia ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Phyllis Atta Parbey ◽  
Elvis Tarkang ◽  
Emmanuel Manu ◽  
Hubert Amu ◽  
Martin Amogre Ayanore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Supplementation ◽  
Case Control Study ◽  
Dietary Diversity ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Categorical Variables ◽  
Children Under Five ◽  
Under Five ◽  
Control Study

Background. Anaemia is one of the major causes of death among children under five years in Ghana. We examined the risk factors of anaemia among children under five years in the Hohoe Municipality, Ghana. Methods. This facility-based matched case control study recruited 210 children (70 cases and 140 controls) aged 6 to 59 months. Stratified and simple random sampling techniques were used to select mothers attending Child Welfare Clinic (CWC) for the screening of their children. Data were collected using a semistructured questionnaire. Finger prick blood was collected to estimate the haemoglobin (Hb) level and thick film was prepared to determine malaria parasitaemia. Axillary temperature was measured using an +electronic thermometer and anthropometric measurements were done using a weighing scale and inelastic tape measure. Continuous variables were presented as means and standard deviations and categorical variables as frequencies and proportions. Conditional logistic regression was used to determine the strength of association between the dependent and the independent variables. Statistical significance was considered at p value of <0.05. Results. The prevalence of anaemia was high (53.8%), while children whose mothers received iron supplementation during pregnancy were 7.64 times more likely to be anaemic compared with those who did not [AOR=7.64 (95% CI:1.41-41.20.93); p=0.018]. Children with poor dietary diversity were 9.15 times more likely to have anaemia [AOR=9.15 (95% CI: 3.13-26.82); p< 0.001]; and children whose mothers were farmers and traders were 83% [AOR = 0.17 (95% CI: 0.05-0.60); p=0.006] and 79% [AOR=0.21 (95% CI: 0.06-0.74); p=0.014], respectively, less likely to have anaemia. Conclusion. The biologic, intermediate, and underlying factors that were significantly associated with anaemia comprised maternal iron supplementation, poor dietary diversity, farmers, and traders. Given that iron supplementation during pregnancy did not protect children against anaemia, we recommend the child’s nutritional dietary diversity is encouraged.

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