Trend of stillbirth rates and the associated risk factors in Babol, northern Iran

ABSTRACT

Stillbirth is an important public health concern and its rate indicates the sanitary development of society. The purpose of this study is to determine the trend of stillbirth rates and its risk factors in Babol. A retrospective study was conducted based on the data of hospital charts of two major Gynecological wards in Shahid Yahyanejat and Babol clinic hospitals in Babol, Northern Iran. In the first phase, the frequencies of stillbirths and live birth deliveries were collected for the period of 1999-2008. In the second phase, a case-control study of 150 stillbirths cases and 300 live births as controls was conducted. The risk factors data included maternal age, gestational age, gravity, history of stillbirth, abortion, diabetes mellitus, preeclampsia, fetal sex, residence area, birth interval and prenatal care. The odds ratio for risk factors with 95% confidence interval for stillbirths was calculated using the logistic regression model. Stillbirth rate was reduced significantly from 10.51 in 1999 to 8.57 per 1000 deliveries in 2008 [p=0.001]. A significant association was found between preterm delivery [p=0.001] and preeclampsia [p=0.01] with stillbirths. Although the proportion of stillbirths was higher among mothers with history of diabetes, abortion and maternal age of more than 35 years, the odds ratio was not statistically significant. There is a relationship between stillbirth, preterm delivery and preeclampsia. Thus, we can considerably prevent stillbirths with sanitary remedial interference on these risk factors