Stillbirths in Jordan: rate, causes, and preventability

BMC Pregnancy Childbirth

et al. 2020

Self Cite

Background Annually, 2.6 million stillbirths occur around the world, with approximately 98% occurring in low- and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyze, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analyzed. Results A total of 10,328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths), with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of the placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations, deformations and chromosomal abnormalities, other specified intrapartum disorders, and intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of the placental cord and membranes. In the multivariate analysis, small for gestational age (SGA) pregnancies were associated with a significant 3-fold increased risk of stillbirth compared to appropriate for gestational age (AGA) pregnancies. Conclusions Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for the early identification of high-risk pregnancies, including the early detection of SGA pregnancies, and ensuring adequate antenatal obstetric interventions.

Section: Introductionmentioning

confidence: 75%

Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system

BMC Pregnancy Childbirth

et al. 2020

Self Cite

“…The rate is higher than the rate of 7.81 per 1000 births that was reported in a multi-ethnic Middle-Eastern based study (5), and that was reported for the year 2015 for some other Arab countries such as Libya (8.8 per 1000 live births), Oman (8.5 per 1000 live births), Qatar (5.8 per 1000 live births), and Kuwait (5.1 per 1000 live births) (11). However, the rate was lower than the rate of 11.6 per 1000 live births that was reported in a previous Jordan study in 2012 (8), and the 2015 rates in other countries such Syria (11.1), Saudia Arabia (13.9), Egypt (12.2), Iraq (15.5), and Jordan (10.5) (11). This decline is promising and might be related to improvements in maternal and child health care, yet there remains a room for more improvement.…”

Section: Discussionmentioning

confidence: 60%

“…One study in Jordan has reported stillbirth rate during the period 2011-2012 and showed a stillbirth rate of 10.6 per 1000 total births (8). This study reported maternal diseases, immaturity, congenital anomalies, unexplained antepartum stillbirths, obstetric complications, placental conditions, and multiple births as the main causes of stillbirths.…”

Section: Introductionmentioning

confidence: 72%

Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Surveillance (JSANDS) system

et al. 2020

Preprint

Self Cite

Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries.Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their causes. Data on births, stillbirths and their causes, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysed.Results: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main fetal causes of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main maternal causes of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Fetal causes of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Maternal causes of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6).Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.

“…One study in Jordan has reported stillbirth rate during the period 2011-2012 and showed a stillbirth rate of 10.6 per 1000 total births (7). This study reported maternal diseases, unexplained immaturity, congenital anomalies, unexplained antepartum stillbirths, obstetric complications, placental conditions, and multiple births as the main contributing conditions of stillbirths.…”

Section: Introductionmentioning

confidence: 70%

Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system

et al. 2020

Preprint

Self Cite

Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions contributing, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysedResults: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6). Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.