title: Factors associated with post-cesarean stillbirth in 12 hospitals in Benin: a cross-sectional.
abstract: BACKGROUND
  In spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin.
  
  
  METHODS
  Cross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%.
  
  
  RESULTS
  There were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors.
  
  
  CONCLUSIONS
  The majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin.
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Virginie
authors.initials: V
authors.lastname: Mongbo
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Edgard-Marius
authors.initials: EM
authors.lastname: Ouendo
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Victoire
authors.initials: V
authors.lastname: Agueh
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Alphonse
authors.initials: A
authors.lastname: Kpozèhouen
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Sopoh
authors.affiliation: Regional Institute of Public Health, University of Abomey-Calavi, BP 384 Ouidah, Benin.
authors.forename: Jacques
authors.initials: J
authors.lastname: Saïzonou
authors.affiliation: Université Libre de Bruxelles. 808 Route de Lennik 1070 Bruxelles, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Godin
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D001541:Benin / Q000453:epidemiology; D001724:Birth Weight; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D065840:Protective Factors; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult
keywords: Benin; Stillbirth; caesarean section