Predictors of stillbirths in a peri-urban referral facility in Northern Region, Ghana

BackgroundStillbirth 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. ObjectiveThis study aimed to determine the prevalence and associated maternal factors of stillbirths in semi-rural Ghana. DesignThis is a cross-sectional study that utilised a quantitative approach. MethodsThe 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. ResultsStillbirth 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. ConclusionThe 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 program 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. Plain language summaryStillbirth, which is the death of a baby occuring before or during childbirth, not only remain a public health issue but also cause emotional distress for mothers in most African countries. Despite the importance of understanding the maternal factors of stillbirths, there is limited data available, especially in semi-rural areas of Ghana. A study was therefore undertaken to assess the prevalence and maternal factors associated with stillbirths in semi-rural Ghana. This study involved women who gave birth in public health facilities and live in the Savelugu Municipal area. Researchers collected data through structured interviews and from medical records. The data were analysed using chi-square tests and logistic regression to identify maternal factors linked to stillbirths. The findings showed a stillbirth rate of 4.0%. Key factors associated with stillbirths included maternal anaemia in the third trimester of pregnancy, positive sickle cell status, and not using insecticide-treated bed nets (ITNs) during pregnancy. The study highlights the need for improved health education on nutrition and safe health practices to reduce and/or prevent stillbirths. Priority should be given to managing medical conditions such as anaemia in pregnancy and sickle cell disease, alongside promoting the use of ITNs to safeguard pregnant women against malaria and subsequently reduce the risk of stillbirths.