Martin Chebet, Peter Olupot-Olupot, Andrew D Weeks, Ingunn Marie S Engebretsen, Noela Regina Akwi Okalany, Francis Okello, Thorkild Tylleskär, Kathy Burgoine, David Mukunya
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Using structured questionnaires, details of maternal health, pregnancy and birth were captured.</p><p><strong>Results: </strong>We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9).</p><p><strong>Conclusion: </strong>Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. 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引用次数: 0
摘要
背景：全世界每年发生190万例死产，其中150万例发生在撒哈拉以南非洲（SSA）和东南亚。目的：本研究旨在确定乌干达东部足月死产的发生率和危险因素，并描述其潜在原因。方法：这是一项队列研究，纳入了妊娠34周及以上的孕妇，并在2021年1月至2024年1月期间随访至分娩。登记和随访由训练有素的助产士在社区完成。通过结构化的问卷调查，收集了孕产妇健康、怀孕和分娩的细节。结果：我们招募了6101名参与者，分析了5496例足月死产发生率和5296例危险因素。在参与者中，4913/5296（92.8%）在14至35岁之间，4456/5296（84.1%）在卫生机构出生。足月死产101例（产时61例，产前40例）。足月死产的发生率为18.4 / 1000 （95% CI 14.8 ~ 22.9）。死产最常见的潜在原因是分娩时间延长或难产32/101（31.7%）和疟疾20/101（19.8%）。与足月死产相关的因素是剖腹产(aRR 3.3；95% CI 2.00 - 5.4)，亲密伴侣暴力(aRR 1.8；95% CI 1.1 - 2.8)和母亲年龄大于35岁(aRR 2.2；95% CI 1.2 - 3.9)。结论：乌干达东部足月死产率很高，超过一半发生在分娩期间。需要努力提高生育护理的质量，防止亲密伴侣暴力。
Term stillbirths in Eastern Uganda: a community-based prospective cohort study.
Background: Every year, 1.9 million stillbirths occur worldwide, of whom 1.5 million occur in sub-Saharan Africa (SSA) and Southeast Asia.
Objectives: This study aims to determine the incidence and risk factors and to describe underlying causes for term stillbirths in Eastern Uganda.
Methods: This was a cohort study of pregnant women enrolled at 34 weeks of gestation or more and followed to birth between January 2021 and January 2024. Enrolment and follow-up were done in the community by trained midwives. Using structured questionnaires, details of maternal health, pregnancy and birth were captured.
Results: We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9).
Conclusion: Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. Efforts are needed to improve the quality of birth care and to prevent intimate partner violence.
期刊介绍：
Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research.
Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health.
Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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