Stillbirths in urban Guinea-Bissau: A hospital- and community-based study.
BACKGROUND:Stillbirth rates remain high in many low-income settings, with fresh (intrapartum) stillbirths accounting for a large part due to limited obstetrical care. We aimed to determine the stillbirth rate and identify potentially modifiable factors associated with stillbirth in urban Guinea-Biss...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5965864?pdf=render |
| _version_ | 1818206040286560256 |
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| author | Morten Bjerregaard-Andersen Najaaraq Lund Anne Sofie Pinstrup Joergensen Frida Starup Jepsen Holger Werner Unger Mama Mane Amabelia Rodrigues Staffan Bergström Christine Stabell Benn |
| author_facet | Morten Bjerregaard-Andersen Najaaraq Lund Anne Sofie Pinstrup Joergensen Frida Starup Jepsen Holger Werner Unger Mama Mane Amabelia Rodrigues Staffan Bergström Christine Stabell Benn |
| author_sort | Morten Bjerregaard-Andersen |
| collection | DOAJ |
| description | BACKGROUND:Stillbirth rates remain high in many low-income settings, with fresh (intrapartum) stillbirths accounting for a large part due to limited obstetrical care. We aimed to determine the stillbirth rate and identify potentially modifiable factors associated with stillbirth in urban Guinea-Bissau. METHODS:The study was carried out by the Bandim Health Project (BHP), a Health and Demographic Surveillance System site in the capital Bissau. We assessed stillbirth rates in a hospital cohort consisting of all deliveries at the maternity ward at the National Hospital Simão Mendes (HNSM), and in a community cohort, which only included women from the BHP area. Stillbirth was classified as fresh (FSB) if fetal movements were reported on the day of delivery. RESULTS:From October 1 2007 to April 15 2013, a total of 38164 deliveries were registered at HNSM, among them 3762 stillbirths (99/1000 births). Excluding deliveries referred to the hospital from outside the capital (9.6%), the HNSM stillbirth rate was 2786/34490 births (81/1000). During the same period, 15462 deliveries were recorded in the community cohort. Of these, 768 were stillbirths (50/1000). Of 11769 hospital deliveries among women from Bissau with data on fetal movement, 866 (74/1000) were stillbirths, and 609 (70.3%) of these were FSB, i.e. potentially preventable. The hospital FSB rate was highest in the evening from 4 pm to midnight (P = 0.04). In the community cohort, antenatal care (ANC) attendance correlated strongly with stillbirth reduction; the stillbirth rate was 71/1000 if the mother attended no ANC consultations vs. 36/1000 if she attended ≥7 consultations (P<0.001). CONCLUSION:In Bissau, the stillbirth rate is alarmingly high. The majority of stillbirths are preventable FSB. Improving obstetrical training, labour management (including sufficient intrapartum monitoring and timely intervention) and hospital infrastructure is urgently required. This should be combined with proper community strategies and additional focus on antenatal care. |
| first_indexed | 2024-12-12T04:06:42Z |
| format | Article |
| id | doaj.art-03e65a1e50de470490dbb5ef072b2cf5 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T04:06:42Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-03e65a1e50de470490dbb5ef072b2cf52022-12-22T00:38:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01135e019768010.1371/journal.pone.0197680Stillbirths in urban Guinea-Bissau: A hospital- and community-based study.Morten Bjerregaard-AndersenNajaaraq LundAnne Sofie Pinstrup JoergensenFrida Starup JepsenHolger Werner UngerMama ManeAmabelia RodriguesStaffan BergströmChristine Stabell BennBACKGROUND:Stillbirth rates remain high in many low-income settings, with fresh (intrapartum) stillbirths accounting for a large part due to limited obstetrical care. We aimed to determine the stillbirth rate and identify potentially modifiable factors associated with stillbirth in urban Guinea-Bissau. METHODS:The study was carried out by the Bandim Health Project (BHP), a Health and Demographic Surveillance System site in the capital Bissau. We assessed stillbirth rates in a hospital cohort consisting of all deliveries at the maternity ward at the National Hospital Simão Mendes (HNSM), and in a community cohort, which only included women from the BHP area. Stillbirth was classified as fresh (FSB) if fetal movements were reported on the day of delivery. RESULTS:From October 1 2007 to April 15 2013, a total of 38164 deliveries were registered at HNSM, among them 3762 stillbirths (99/1000 births). Excluding deliveries referred to the hospital from outside the capital (9.6%), the HNSM stillbirth rate was 2786/34490 births (81/1000). During the same period, 15462 deliveries were recorded in the community cohort. Of these, 768 were stillbirths (50/1000). Of 11769 hospital deliveries among women from Bissau with data on fetal movement, 866 (74/1000) were stillbirths, and 609 (70.3%) of these were FSB, i.e. potentially preventable. The hospital FSB rate was highest in the evening from 4 pm to midnight (P = 0.04). In the community cohort, antenatal care (ANC) attendance correlated strongly with stillbirth reduction; the stillbirth rate was 71/1000 if the mother attended no ANC consultations vs. 36/1000 if she attended ≥7 consultations (P<0.001). CONCLUSION:In Bissau, the stillbirth rate is alarmingly high. The majority of stillbirths are preventable FSB. Improving obstetrical training, labour management (including sufficient intrapartum monitoring and timely intervention) and hospital infrastructure is urgently required. This should be combined with proper community strategies and additional focus on antenatal care.http://europepmc.org/articles/PMC5965864?pdf=render |
| spellingShingle | Morten Bjerregaard-Andersen Najaaraq Lund Anne Sofie Pinstrup Joergensen Frida Starup Jepsen Holger Werner Unger Mama Mane Amabelia Rodrigues Staffan Bergström Christine Stabell Benn Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. PLoS ONE |
| title | Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. |
| title_full | Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. |
| title_fullStr | Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. |
| title_full_unstemmed | Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. |
| title_short | Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. |
| title_sort | stillbirths in urban guinea bissau a hospital and community based study |
| url | http://europepmc.org/articles/PMC5965864?pdf=render |
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