Factors associated with fresh stillbirths in Livingstone district, Zambia.

Abstract

Introduction: Over a million fresh stillbirths occur every year, and they are attributed to acute intrapartum events. Good, timely and appropriate midwifery care provided by skilled attendants in an environment that is favourable prevents or at least decreases the incidence of fresh stillbirths. The aim of this study was to determine factors associated with fresh stillbirths in Livingstone district, Zambia. Methods: This was a descriptive cross sectional study in which a checklist was used to collect data from files of 245 women who had birthed at Livingstone Central hospital, and a semi-structured self administered questionnaire adapted from the World Health Organisation (WHO) was used to collect data from 35 midwives from Livingstone Central Hospital and three clinics in the district. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23. Relationships between variables were ascertained using Chi-square and Fisher‟s Exact tests. Multivariate logistic regression was used to control for confounding variables and to come up with an independent contributing factor for fresh stillbirths. To ascertain the significance of a result, 95% Confidence Intervals and 5% level of significance was used. Results: The findings revealed that foetal and maternal related complications were associated with fresh stillbirths in the district. The association between maternal complications and fresh stillbirths was statistically significant with a p-value of 0.013; while that between foetal complication and fresh stillbirth was 0.001. Regarding knowledge, 71.4% of midwives had low knowledge levels on fresh stillbirths, while 80% reported not having received in-house training on emergency management of maternal and neonatal emergencies. Foetal related factors associated with fresh stillbirths were cord accidents (p-value 0.040) and prematurity (p-value 0.003). Additionally, mothers whose occupation was trading had 5.5 more times Odds of having fresh stillbirths, with p value of 0.021. Conclusion: The conclusion of the study is that it is important to ensure that quality antenatal and intrapartum care are provided to all women, in particular those in the occupation of trading, to ensure timely diagnosis and appropriate management of maternal and foetal complications. There is also need to conduct in-house training for midwives in the diagnosis and management of maternal and foetal complications. Key words – Fresh stillbirths, antenatal, intrapartum care