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Obstetrics and Gynecology International
Volume 2010 (2010), Article ID 186867, 8 pages
http://dx.doi.org/10.1155/2010/186867
Research Article

Stillbirths in Rural Hospitals in The Gambia: A Cross-Sectional Retrospective Study

1Section for International Health, Department of General Practice and Community Medicine, Institute of Health and Society, University of Oslo, Blindern, 0317 Oslo, Norway
2Oslo University Hospital, Department of Obstetrics and Gynaecology, National Resource Centre for Women’s Health, N-0027 Oslo, Norway
3Section for International Health, Department of General Practice and Community Medicine, Institute of Health and Society, University of Oslo, P.O. BOX 1130 Blindern, N-0318 Oslo, Norway

Received 17 March 2010; Accepted 18 May 2010

Academic Editor: Liliana S. Voto

Copyright © 2010 Abdou Jammeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. We determined the stillbirth rate and associated factors among women who delivered in rural hospitals in The Gambia. Method. A cross-sectional retrospective case review of all deliveries between July and December 2008 was undertaken. Maternity records were reviewed and abstracted of the mother’s demographic characteristics, obstetric complications and foetal outcome. Main Outcome Measure: The stillbirth rate was calculated as deaths per 1000 births. Results. The hospital-based stillbirth rate was high, 156 (95% CI 138–174) per 1000 births. Of the 1,519 deliveries, there were 237 stillbirths of which 137 (57.8%) were fresh. Severe obstetric complication, birth weight <2500 g, caesarean section delivery, and referral from a peripheral health facility were highly significantly associated with higher stillbirth rates, OR = 6.68 (95% CI 3.84–11.62), 4.47 (95% CI 3.04–6.59), 4.35 (95% CI 2.46–7.69), and 3.82 (95% CI 2.24–6.51), respectively. Half (50%) of the women with stillbirths had no antenatal care OR = 4. 46(95% CI 0.84–23.43). Conclusion. We observed an unacceptably high stillbirth rate in this study. As most of the stillbirths were fresh, improved intrapartum care supported by emergency transport services and skilled personnel could positively impact on perinatal outcomes in rural hospitals in The Gambia.