Stillbirth is when a baby dies after 28 weeks of pregnancy or more than 1000 g but before or during birth. Stillbirths are classified into macerated or fresh stillbirths depending on when they occur [1]. Macerated stillbirth is the intrauterine death of a foetus before the onset of labour where the foetus has shown degenerative changes while fresh stillbirth is the intrauterine death of a foetus during labour or delivery [1].
Stillbirths are a growing public health concern. The United Nations Inter-Agency Group for Child Mortality Estimation released its first-ever global stillbirth estimates in 2020, which revealed that the ratio of the number of stillbirths to the number of under-five deaths has increased from 0.77 in 2000 to 0.82 million in 2019, globally [2]. The global estimate of stillbirths is 2 million babies yearly, with three out of 4 stillbirths occurring in Sub-Saharan Africa (SSA) or Southern Asia [2]. In SSA, the stillbirth rate stands at 21.7 per 1,000 total births. Stillbirths are often underreported, so even these numbers may be underestimated [1, 3, 4].
In low- and middle-income settings, maternal conditions associated with stillbirth include hypertension, diabetes, maternal infection (e.g. syphilis, malaria, HIV), maternal undernutrition, obesity, and smoking [5]. Other factors which significantly contribute to stillbirths include: foetal asphyxia, trauma, prolonged labour, congenital infections, and foetal distress [6, 7].
With quality health care throughout pregnancy and childbirth, most stillbirths are preventable. In Uganda, the rate of stillbirths in 2015 was 21/1,000 live births. In 2021, a study in a hospital in the Northern part of Uganda showed a stillbirth rate of 20 deaths per 1,000 deliveries [8]. The government of Uganda has ensured that there are health facilities within every 5 km radius to help mothers easily access healthcare.
[9], it has also provided free antenatal care services where mama-kits are distributed to help mothers and their unborn babies during delivery [10]. Public health facilities also provide folic acid and iron supplementation, prevention of malaria through providing intermittent preventive treatment and distribution of treated mosquito nets, and improved detection and management of syphilis to pregnant women to improve pregnancy outcomes.
In 2014, the World Health Organisation developed an action plan to prevent stillbirths. This plan, called the Every Newborn Action Plan (ENAP), was adopted by Uganda and targets a reduction in stillbirth rates to 11]. The plan involves supporting government leadership and providing guidance on how to strengthen newborn health components in existing health sector plans and strategies, especially those that relate to reproductive, maternal, and child health. However, little is known about stillbirth rates in Uganda since ENAP was introduced. We assessed the distribution, temporal, and spatial trends of stillbirths in Uganda, 2014–2020, to inform programming for safe pregnancies and deliveries in the country.
Source link : https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06434-x
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Publish date : 2024-04-08 07:00:00
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