Maternal risk factors contributing to stillbirths in semi-rural Ghana: Insights from a cross-sectional study.

Abstract

Background: Stillbirth remains a critical public health challenge in low- and middle-income countries, impeding progress toward achieving the Sustainable Development Goals. Given the diverse dynamics of the prevalence and associated factors of stillbirths in various low-resource settings, such as Ghana, it is essential to have comprehensive knowledge to address and mitigate these factors that could influence stillbirths. However, there is a paucity of data on maternal factors contributing to stillbirths in semi-rural areas of Ghana.

Objective: This study aimed to determine the prevalence and associated maternal factors of stillbirths in semi-rural Ghana.

Design: This is a cross-sectional study that utilised a quantitative approach.

Methods: The study was conducted among 422 mothers who delivered in public health facilities and reside in the Savelugu Municipality of Northern Ghana. Sociodemographic, obstetric, and medical-related data were gathered through structured interviews and from record reviews. Chi-square test of proportions and multiple logistic regression analyses were employed to identify the independent factors associated with stillbirths at a 95% confidence level.

Results: Stillbirth rate was estimated at 4.0% (95%CI: 2.4%-6.4%). The analysis revealed that anaemia in the third trimester of pregnancy (aOR:3.15; 95%CI:2.94-6.10; p = 0.034), positive sickle cell status (aOR:2.91; 95%CI:2.50-5.01; p = 0.018), and non-utilisation of insecticide-treated bed nets (ITNs) (aOR:7.75; 95%CI:4.33-8.80; p = 0.001) during pregnancy were significantly associated with increased risk of stillbirths.

Conclusion: The relatively high prevalence of stillbirths in the municipality was influenced by medical factors (particularly anaemia and positive sickle cell status) and unsafe health practices via the non-use of ITNs during pregnancy. The management of the Ghana Health Service, alongside programme planners and other stakeholders involved in enhancing perinatal and maternal health, should focus on implementing effective initiatives such as improved health education on nutrition and safety practices at the facility and community levels, as well as robust referral systems to prevent and reduce stillbirths in semi-rural Ghana.