Association between obstetric and medical risk factors with stillbirths in a low-income urban setting.

OBJECTIVE To evaluate the association between obstetric and medical risk factors with stillbirths (SB) in a Kenyan setup. MATERIAL AND METHODS A case-control study was conducted in four hospitals between August 2018 and April 2019. Two hundred and fourteen (214) women with stillbirths and 428 with livebirths >28 weeks' gestation were enrolled. Data collection was via interviews and abstraction from medical records. Outcome variables were stillbirth and livebirth; exposure variables were sociodemographic characteristics, medical and obstetric factors. The two-sample t-test and Chi-square test were used to compare continuous and categorical variables respectively. The association between the exposure and outcome variable was done using logistic regression. A p-value <0.05 was considered statistically significant. RESULTS Stillbirth was associated with pre-eclampsia without severe features (OR 9.1, 95% CI 2.6-32.5), with severe features (OR 7.4, 95% CI 2.4-22.8); eclampsia (OR 9.2, 95% CI 2.6-32.5), placenta previa (OR 8.6 95% CI 2.8-25.9), abruptio placenta (OR 6.9 95% CI 2.2-21.3), preterm delivery(OR 9.5, 95% CI 5.7-16), and gestational diabetes mellitus (GDM), (OR11.5, 95% CI 2.5-52). SB was not associated with multiparity, anaemia and HIV. CONCLUSION Proper antepartum care and surveillance to identify and manage medical and obstetric conditions with a potential of causing stillbirth are recommended.