Determining the Causes and Risk Factors of Stillbirths at GPHC

Abstract

Background: Although a worldwide issue, the burden of stillbirths is mostly upon middle- and low-income countries [1,2]. SDG for stillbirths has a target of 12 or fewer stillbirths per 1000 total births in all countries. Guyana, a middle-income country at the brink of achieving the upper limit for UN’s SDG for stillbirths, in the year 2030 [1,3,4]. GPHC is the main tertiary, referral, specialist hospital in Guyana. Objectives: This study aimed to determine the stillbirth rate at GPHC during the period of January 1 to July 31, 2021. It also aimed to determine the number of stillbirth cases that were being managed as inpatients vs referral, the number of stillbirth cases that were fresh vs macerated and also the main risk factors and causes of stillbirths at GPHC during the period January 1 to July 31, 2021 Methodology: A quantitative, retrospective, case control study was conducted. Cases included 37 stillbirths occurring at GPHC January 1 to July 31, 2021 that were 28 weeks gestation and older. Controls were 37 livebirths selected at random, meeting the same inclusion criteria as cases. Maternal medical records for cases and controls were review and descriptive statistics was used to analyse data extracted from charts. Results: Stillbirth rate at GPHC from January 1 to July 31, 2021 was found to be 11.96 per 1000 births. More stillbirths were managed as referral (24 cases) vs inpatients (13 cases). Most stillbirths were macerated (68.57%) vs fresh (31.43%). Possible risk factors of stillbirth at GPHC include male sex, referral management, HTN disease, DM disease, not having antenatal labs done, having less than 8 ANC clinic visits, multiparity, preterm and post term gestation, advanced maternal age and being 35 and older. Most common cause of stillbirths was placenta abruption. Most common maternal condition is complications of placenta cord and membrane. The most common antepartum cause is foetal death unspecified, while the most common intrapartum cause was is acute intrapartum event. Conclusion: This study shows that there is improvement of stillbirth rate at GPHC. However, before the results from this study can be extrapolated onto Guyana, other comparative studies should be done.