Determinants of stillbirths in Northern Ghana: a case control study.
BACKGROUND
Stillbirths are more common than the death of a baby after birth. In 2012, Tamale Metropolitan Area in the Northern Region of Ghana reported 35 stillbirths per 1,000 deliveries. This study was therefore conducted to determine the sociodemographic, obstetric and maternal medical health related risk factors associated with stillbirths.


METHODS
A 1:1 unmatched case control study was conducted in the Tamale Metropolis. Cases were defined as singleton lifeless babies delivered by resident mothers in Tamale Metropolis at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live babies within the same period. We abstracted data from maternal health record booklets used in index pregnancies. We also conducted personal interviews with mothers on home visits. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values.


RESULTS
A total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24 years, prolonged labour (> 12 hours) and diastolic blood pressure of less than 80mmHg in late pregnancy were significant determinants of stillbirths (aOR = 3.0, 95% CI 1.08 - 8.39; aOR = 3.5, 95% CI 1.94 - 6.61; aOR =2.2, 1.04 - 4.54 respectively).


CONCLUSIONS
Low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Meetropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized.
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana; Ghana Health Service, Northern Regional Health Directorate, Tamale, Ghana.
Adam Bukari
AB
Badimsuguru
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Kofi Mensah
KM
Nyarko
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Edwin Andrew
EA
Afari
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Samuel Oko
SO
Sackey
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana; Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Chrysantus
C
Kubio
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007743:Labor, Obstetric; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
Stillbirth; Tamale Metropolitan Area; case control; determinants; study