Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Sectio Ceasarea | Research article

Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study

Authors: Friday E. Okonofua, Lorretta Favour C. Ntoimo, Rosemary Ogu, Hadiza Galadanci, Gana Mohammed, Durodola Adetoye, Eghe Abe, Ola Okike, Kingsley Agholor, Rukiyat Abdus-salam, Abdullahi Randawa

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

Login to get access

Abstract

Background

In 2015, Nigeria’s estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths. This suggests that Nigeria still makes substantial contribution to the global burden of stillbirths. This study was conducted to determine the prevalence and identify the causes and factors associated with stillbirth in eight referral hospitals in Nigeria.

Methods

This was a cross-sectional study of all deliveries over a period of 6 months in six general hospitals (4 in the south and 2 in the north), and two teaching hospitals (both in the north) in Nigeria. The study population was women delivering in the hospitals during the study period. A pre-tested study protocol was used to obtain clinical data on pregnancies, live births and stillbirths in the hospitals over a 6 months period. Data were analyzed centrally using univariate, bivariate and multivariate logistic regression analyses. The main outcome measure was stillbirth rate in the hospitals (individually and overall).

Results

There were 4416 single births and 175 stillbirths, and a mean stillbirth rate of 39.6 per 1000 births (range: 12.7 to 67.3/1000 births) in the hospitals. Antepartum (macerated) constituted 22.3% of the stillbirths; 47.4% were intrapartum (fresh stillbirths); while 30.3% was unclassified. Acute hypoxia accounted for 32.6% of the stillbirths. Other causes were maternal hypertensive disease (6.9%), and intrapartum unexplained (5.7%) among others. After adjusting for confounding variables, significant predictors of stillbirth were referral status, parity, past experience of stillbirth, birth weight, gestational age at delivery and mode of delivery.

Conclusion

We conclude that the rate of stillbirth is high in Nigeria’s referral hospitals largely because of patients’ related factors and the high rates of pregnancy complications. Efforts to address these factors through improved patients’ education and emergency obstetric care would reduce the rate of stillbirth in the country.

Trial registration

Trial Registration Number NCTR91540209.
Nigeria Clinical Trials Registry. http://​www.​nctr.​nhrec.​net/​
Registered April 14th 2016.
Literature
1.
2.
Blencowe H, Cousens S, Jassir FB, Say L, Chou D, Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4(2):e98–108.CrossRef
3.
Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587–603.CrossRef
4.
National Population Commission (NPC) [Nigeria] and ICF International. Nigeria Demographic and Health Survey 2013. Abuja, and Rockville: NPC and ICF International; 2014.
5.
Okeudo C, Ezem B, Ojiyi E. Stillbirth rate in a teaching Hospital in South-Eastern Nigeria: a silent tragedy. Ann Med Health Sci Res. 2012;2(2):176–9.CrossRef
6.
Onyiriuka AN. Analysis of stillbirths in a Nigerian mission hospital. Niger Q J Hosp Med. 2009;19(1):27–31.
7.
Mutihir JT, Eka PO. Stillbirths at the Jos University teaching hospital: incidence, risk, and etiological factors. Niger J Clin Pract. 2011;14(1):14–8.CrossRef
8.
9.
Audu BM, Alhaji MA, Takai UI, Bukar M. Risk factors for stillbirths at universty of Maiduguri teaching hospital, Maiduguri, Nigeria: a cross-sectional retrospective analysis. Niger Med J. 2009;50(2):42.
10.
Njoku CO, Emechebe CI, Eyong EM, Ukaga JT, Anachuna KC. Prevalence and risk factors for stillbirths in a tertiary hospital in Niger Delta area of Nigeria: a ten year review. Int J Med Biomed Res. 2016;5(3):106–13.CrossRef
11.
NPHCDA. National Primary Health Care Development Agency: minimum standards for primary health Care in Nigeria [internet]. Abuja: Department of Planning, Research and Statistics, National Primary Health Care Development Agency; 2012. Available from: www.​nphcda.​gov.​ng
12.
Ejembi C, Alti-Muazu M, Chirdan O, Ezeh H, Sheidu S, Dahiru T. Utilization of maternal health services by rural Hausa women in Zaria environs, northern Nigeria: has primary health care made a difference? J Community Med Prim Health Care. 2004;16(2):47–54.
13.
Babatunde OA, Aiyenigba E, Awoyemi OA, Akande TM, Musa OI, Salaudeen AG, et al. Primary health care consumers’ perception of quality of care and its determinants in north-Central Nigeria. J Asian Sci Res. 2013;3(7):775–85.
14.
Egbewale B, Odu O. Perception and utilization of primary health Care Services in a Semi-Urban Community in South-Western Nigeria. J Community Med Prim Health Care. 2013;24(1–2):11–20.
15.
Nkwo PO. Poor availability of skilled birth attendants in Nigeria: a case study of Enugu state primary health care system. Ann Med Health Sci Res. 2015;5(1):20–5.CrossRef
16.
17.
Goldenberg RL, McClure EM. Importance of prenatal care in reducing stillbirth. BJOG. 2018;125(2):148.CrossRef
18.
Lavin T, Pattinson RC. Does antenatal care timing influence stillbirth risk in the third trimester? A secondary analysis of perinatal death audit data in South Africa. BJOG. 2018;125(2):140-7.CrossRef
19.
Fagbamigbe AF, Idemudia ES. Wealth and antenatal care utilization in Nigeria: policy implications. Health Care Women Int. 2017;38(1):17–37.CrossRef
20.
Oladapo OT, Adetoro OO, Ekele BA, Chama C, Etuk SJ, Aboyeji AP, et al. When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country. BJOG Int J Obstet Gynaecol. 2016;123(6):928–38.CrossRef
21.
Fawole AO, Shah A, Tongo O, Dara K, El-Ladan AM, Umezulike AC, et al. Determinants of perinatal mortality in Nigeria. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2011;114(1):37–42.CrossRef
22.
Mallick L, Tukur D, Kerry M. Trends in Maternal Health in Nigeria, 2003-2013. DHS further analysis reports no 102. Rockville: ICF International; 2016.
23.
Hussein J, Hirose A, Owolabi O, Imamura M, Kanguru L, Okonofua F. Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care. Reprod Health. 2016;13(1):47.CrossRef
24.
Bazuaye A, Okonofua FE. Tackling maternal mortality in Africa after 2015: what should the priorities be? Afr J Reprod Health. 2013;17(2):9–17.PubMed
25.
Gülmezoglu AM, Lawrie TA, Hezelgrave N, Oladapo OT, Souza JP, Gielen M, et al. Interventions to Reduce Maternal and Newborn Morbidity and Mortality. In: Black RE, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, vol. 2. 3rd ed. Washington: The International Bank for Reconstruction and Development / The World Bank; 2016. [cited 2017 Jul 29]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK361904/​.
26.
Okonofua FE, Abejide A, Makanjuola RA. Maternal mortality in Ile-Ife, Nigeria: a study of risk factors. Stud Fam Plan. 1992;23(5):319–24.CrossRef
27.
28.
Okonofua F. Optimising caesarean-section rates in West Africa. Lancet. 2001;358(9290):1289.CrossRef
29.
Ojiyi E, Dike E, Anolue F, Chukwulebe A. Appraisal of caesarean section at the IMO state university teaching hospital, Orlu, southeastern Nigeria. Internet J Gynecol Obstet. 2012;16(2):1-6.
30.
Adeniran AS, Aboyeji AP, Fawole AA, Balogun OR, Adesina KT, Isiaka-Lawal S. Evaluation of parturient perception and aversion before and after primary cesarean delivery in a low-resource country. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2016;132(1):77–81.CrossRef
31.
Aziken M, Omo-Aghoja LA, Okonofua F. Perceptions and attitudes of pregnant women towards caesarean section in urban Nigeria. Acta Obstet Gynecol Scand. 2007;86(1):42-7.CrossRef
Metadata
Title
Prevalence and determinants of stillbirth in Nigerian referral hospitals: a multicentre study
Authors
Friday E. Okonofua
Lorretta Favour C. Ntoimo
Rosemary Ogu
Hadiza Galadanci
Gana Mohammed
Durodola Adetoye
Eghe Abe
Ola Okike
Kingsley Agholor
Rukiyat Abdus-salam
Abdullahi Randawa
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2682-z

Other articles of this Issue 1/2019

BMC Pregnancy and Childbirth 1/2019 Go to the issue

Research article

Prevalence of hyperglycemia in pregnancy and influence of body fat on development of hyperglycemia in pregnancy among pregnant women in urban areas of Arusha region, Tanzania

Research article

A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault

Debate

Re-examination of perinatal mental health policy frameworks for women signalling distress on the Edinburgh Postnatal Depression Scale (EPDS) completed during their antenatal booking-in consultation: a call for population health intervention

Research article

Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition

Research article

Distribution of maternity waiting homes and their correlation with perinatal mortality and direct obstetric complication rates in Ethiopia

Research article

Vitamin D status and its determinants in healthy pregnant women living in Switzerland in the first trimester of pregnancy