Study of the Determinants of Stillbirths in the Reference Health Centers of Selingue and Yorosso (Sikasso Region) From January 1, 2015, to December 31, 2017

Abstract

Mamadou BERTHE, Mamadou SIMA, Fatou DIAWARA, Diakaridia KONE, SAMAKE Alou, DOUMBIA Kounandy, DIALLO Cheickna, TERERA Ibrahim, TEGUETE Ibrahima, TRAORE Youssouf, SANGHO Hamadoun, SYLLA Mariam, DOUMBIA Seydou

Background: Stillbirths remain a major public health problem in sub-Saharan Africa and Mali. According to routine data collected from 2008 to 2016 in Sikasso, the health district of Sélingué had the highest stillbirth rate in the region (51.7 (%) births) and that of Yorosso had the lowest (13.7 (%) births). This led us to initiate this study to study the determinants of stillbirths in the Reference Health Centers of the two districts from January 1, 2015, to December 31, 2017.

Methods: It was a case-control study of 440 cases including 110 cases and 330 controls in each of the Health Centers. The statistical analysis was done on SPSS version 20 and the writing was done on Word. The value of p<0.05 was found to be statistically significant.

Result: The prevalence’s of stillbirths were 28, 6 % in Sélingué and 140 % in Yorosso. The Multivariate Analysis Yielded the Following Results: 1. Women who have not had an antenatal care have a 3 to 4 times higher risk of stillbirths than those who have had antenatal care (OR=3.87; CI: [1.86-8.04]; p=0.000); ambulance transport is a protective factor compared to other means of transport (OR: 0.27; CI: [0.09; 0.77];p=0.015); The following reasons for evacuation were risk factors for stillbirths: painful uterine contractions (OR: 4.23; CI: [1.55-11.55]; p=0.005) and stationary dilatation (OR: 6.04; CI: [1.11; 32.85], p=0.037). 2. In Yorosso, the multivariate analysis selected antenatal care as the only statistically significant risk factor for stillbirths. Women who did not have antenatal care were 4 times more likely to give birth to stillbirths than those who did (OR=4.27; CI: [1.08-16.88]; p=0.038).

Conclusion: In light of these results, we believe that emphasis should be placed on the importance of prevention by strengthening antenatal care and improving evacuation conditions.

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