Study of the determinants of stillbirth at the Sélingué Reference Health Center from January 1st, 2015 to December 31st, 2017.

Study of the determinants of stillbirth at the Sélingué Reference Health Center from January 1st, 2015 to December 31st, 2017.

Mamadou Berthe (1,2), Doumbia Kounandy (2), Kone Diakaridia (3), Sima Mamadou (4), Coulibaly Moustapha (5), Ouassa Berthe (1,2), Sylla Mariam (6), Doumbia Seydou (7)

(1) Directorate General of Health and Public Hygiene; (2) 5: National Institute of Training in Health Sciences; (3) Reference Health Center of Commune I; (4) Department of Obstetrics and Gynecology at the University Hospital Center Point G; (5) Sélingué Reference Health Center; (6) Pediatric Department of the Gabriel TOURE University Hospital Center; (7) Department of Teaching and Research in Public Health London School of Hygiene & Tropical Medicine.

Introduction
Stillbirth is a major public health problem in the African regions south of the Sahara and in Mali. About 2.6 million newborn babies were still counted in 2015 worldwide, about 7,200 stillbirths a day. According to the data of the Local Health Information System over a period from 2008 to 2016 the health district of Sélingué had the highest rate of stillbirth in the Sikasso region (51.7 per 1000 births). This prompted us to conduct this study whose general objective was to study the determinants of stillbirth among parturients at the Sélingué Reference Health Center (CSRéf) from January 1st, 2015 to December 31st, 2017.

Method
This was a retrospective case-control study involving 440 files, including 110 cases and 330 controls. Data entry was done on Epi7, analysis on SPSS version 20 and writing on the Word.

Results
Bivariate analysis showed a statistically significant association between stillbirth and the following factors: primiparity [OR = 2.30 95% CI (1.16, 4.51); p = 0.01], transport by motorcycle [OR = 1.95; 95% CI (1.15, 3.31); p = 0.013], admission modes by other evacuation [OR = 3.35; 95% CI = (1.68, 6.65); p = 0.001] and self-reference [OR = 6.18 95% CI (3.07, 12.41); p = 0.000], prenatal consultation CPN [OR = 2.75 95% CI (1.69, 4.46); p = 0.000] and cord prolapse [OR = 12.86; 95% CI (2.7, 61.5); p = 0.001). Multivariate analysis used as risk factors for stillbirth the non-achievement of ANC [OR = 3.05 95% CI (1.77, 5.26); p = 0.000], non-evacuation by ambulance [OR = 6.59 95% CI (2.96, 14.66); p = 0.000], those that are not self-referred [OR = 6.12 95% CI (2.19, 12.90); p = 0.000]. Ambulance evacuation was a protective factor [OR = 0.25 95% CI (0.18, 0.53); p = 0.000]. Finally cord prolapse [OR = 13.01 95% CI (2.41, 70.22); p = 0.003].

Conclusion
These results once again demonstrate the importance of prevention with a focus on strengthening NPC and improving evacuation conditions.

 

Keywords: Stillbirth; stillbirth; determinants; OR ;

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