Are risk factors for stillbirths in low-income countries associated with sensorineural hearing loss in survivors?
OBJECTIVE
To determine associated risk factors for stillbirths in Lagos, Nigeria and to examine possible relationships between these factors and the risk of sensorineural hearing loss (SNHL).


METHODS
Stillbirths in an inner-city maternity hospital from June 2005 to May 2007 were matched with live-birth controls at ratio 1:2. Risk factors and their associated adjusted odds ratio (OR) at 95% confidence interval (CI) were first determined by multiple logistic regression and then correlated with hearing screening failure among survivors who received a two-stage hearing screening with automated otoacoustic emissions and auditory brainstem response.


RESULTS
Of 201 cases examined and matched with 402 live births, 101 (50.2%) were fresh stillbirths and 100 (49.8%) macerated. Multiparity (OR: 1.92; CI: 1.16-3.20), lack of antenatal care (OR: 7.23; CI: 3.94-13.26), hypertensive conditions (OR: 6.48; CI: 2.94-14.29), antepartum haemorrhage (OR:18.84; CI: 6.96-51.00), premature rupture of membrane (OR:3.36; CI: 1.40-8.05), prolonged obstructed labour (OR: 22.25; CI: 10.07-49.16) and prematurity (OR: 2.30; CI: 1.2-4.01) were associated with increased risk of stillbirths whereas caesarean section (OR: 0.24; CI: 0.12-0.48) was associated with lower risk of stillbirths. Infants delivered by mothers with hypertensive conditions during pregnancy were at risk of SNHL (OR: 2.97; CI: 1.15-7.64).


CONCLUSIONS
Hypertensive conditions during pregnancy increase the risk of stillbirths and place survivors at greater risk of SNHL.
Olusanya
Bolajoko O
BO
Department of Community Health and Primary Care, University of Lagos, Nigeria. boolusanya@aol.com
Afe
Abayomi J
AJ
Solanke
Olumuyiwa A
OA
D000328:Adult; D016022:Case-Control Studies; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology*; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult