Singleton stillbirths in a tertiary public hospital offering free maternity services in southwest Nigeria: A one-year review

Abstract

Stillbirths are major components of perinatal mortalities in Nigeria. The study objectives are to determine the feto-maternal factors associated with antepartum intrauterine fetal deaths (IUFDs) leading to stillbirths as well as compare selected clinical characteristics with normal live births. This prospective observational study was conducted in a free service public hospital in south-western Nigeria. Parturients with antepartum IUFDs had midwives conduct anthropometric measurements and physical examinations on the stillborn babies. Clinical details of two subsequent live births were recorded for comparison. Data was analysed using SPSS v. 23. During the study, there were 3,342 births out of which 243 were stillbirths (72.7 per 1000 births). Antepartum IUFDs resulting in stillbirths were 74 out of which 35 (47%) had identifiable causative factors, mainly placental abruption and hypertensive disorders in pregnancy (HDPs) while the rest were unexplained. Analyses also revealed that lack of antenatal care and intrauterine growth restriction were associated with stillbirths. Placental abruption and HDPs were the commonest known causes of antepartum IUFDs. Therefore, the promotion of universal access to qualitative antenatal care is advocated. In addition, use of customised fetal growth charts should be institutionalised for early identification of growth restriction. Key words: Antepartum, fetal death, stillbirth, free maternity services, south-western Nigeria.