title: Stillbirths and very low Apgar scores among vaginal births in a tertiary hospital in Ghana: a retrospective cross-sectional analysis.
abstract: BACKGROUND
  Data pertaining to risk factors associated with stillbirths and very low Apgar scores is very sparse. This study was conducted to determine the prevalence of, and examine the socio-demographic and obstetric factors associated with stillbirths and very low Apgar scores among vaginal births in a tertiary health facility, Ghana.
  
  
  METHODS
  A retrospective cross-sectional review of vaginal deliveries conducted at a teaching hospital in Ghana from 1st January to 31st December, 2009. Background characteristics and obstetric history of the mother as well as the vital status of the baby at birth were extracted. Risk factors associated with stillbirths and very low Apgar scores were examined using binomial regression with a log-link function, and population attributable fractions calculated for significant risk factors.
  
  
  RESULTS
  Of the 8,758 deliveries which met the inclusion criteria, 5.9% of the babies were stillbirths, and 6.5% and 1.9% of live births had very low Apgar scores in the first and fifth minutes respectively. Preterm delivery, hypertensive disorders in pregnancy, breech delivery and vacuum extraction were significant risk factors for stillbirths and very low Apgar scores in the fifth minute of life. Low birth weight was also a significant risk factor for very low Apgar scores.
  
  
  CONCLUSIONS
  The prevalence of stillbirths and very low Apgar scores were high. Improving the quality of obstetric care during labour and delivery may help improve these adverse vaginal birth outcomes.
authors.affiliation: Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana. edidassah@yahoo.com.
authors.forename: Edward Tieru
authors.initials: ET
authors.lastname: Dassah
authors.forename: Alexander Tawiah
authors.initials: AT
authors.lastname: Odoi
authors.forename: Baafuor Kofi
authors.initials: BK
authors.lastname: Opoku
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001946:Breech Presentation / Q000453:epidemiology; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D050498:Live Birth; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D062606:Tertiary Care Centers; D014620:Vacuum Extraction, Obstetrical; D055815:Young Adult