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  • Title: Still births in a Hausa community.
    Author: Rehan N.
    Journal: J Pak Med Assoc (1951); 1982 Jul; 32(7):156-62. PubMed ID: 12279373.
    Abstract:
    The prevalence and etiology of stillbirths were studied among 3858 Hausa infants born at Maternity Hospital, Katsina, Nigeria from January 1, 1974 through December 31, 1977. Out of the 3858 births 436 were stillbirths giving a stillbirth rate (SBR) of 113/1000 total births. The maternal age range of the mothers of these 436 still births ranged from 13-44 years. 39.6% of them were 20 years or younger. The parity ranged from 0-14. The primipara formed the largest group (34.4%); 20.4% were grand multipara, i.e., parity 7 or more. Most mothers were living in urban areas, yet only 14.9% had attended any antenatal clinic. There was a tendency in SBR for an initial fall with the advancing maternal age and increasing birth order so that the lowest SBR was observed in mothers 23-25 years old and parity 1. Then there was a sharp increase in the SBR with increase both in maternal age and birth order. When age specific SBRs were calculated according to various parities, a slightly different picture emerged, showing the lowest incidence among secundipara of 17-19 years. The SBR was higher in the rural population (165/1000) and unbooked cases (176/1000) as compared to urban population (92/1000) and booked cases (37/1000). The difference in either case was statistically significant. Most stillbirths (75.7%) were fresh and in 86.5% the fetus was dead at the time of admission. There was a preponderance of males (55.5%). Only 34.2% of the stillbirths weighed 2.5 kg or less. The fetal heart sound was not heard at the time of admission in 86.5% cases. In the rest death occurred during the process of labor. In 54 cases no definite etiological factor could be identified. The most prominent factors were abnormal labor (23%), antepartum hemorrhage (17%), and malpresentations (16.5%). There were 172 (39.6%) cases in which the cause of stillbirth could be attributed to the mother. Of these, 27 (6.2%) were due to toxemia, 32 (7.4%) due to rupture of the uterus, 13 (3%) due to maternal diseases, and 100 (23%) due to obstructed labor. The maternal diseases were 1 case of hypertension, 3 cases of hydramnios, 7 cases of anemia, 1 case of acute febrile illness, and 1 case of afibrinogenemia. 115 cases (26.4%) of the total stillbirths could be attributed to fetal factors. Malpresentations and prematurity were the most prominent factors. 95 (21.7%) stillbirths were due to placental or cord factors. There were 21 maternal deaths in this series.
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