Stillbirths in sub-Saharan Africa: unspoken grief

Kiguli, Juliet; Munabi, Ian Guyton; Ssegujja, Eric; Nabaliisa, Joyce; Kabonesa, Consolata; Kiguli, Sarah; Byamugisha, Josaphat

doi:10.1016/s0140-6736(15)01171-x

Cited by 40 publications

(37 citation statements)

References 12 publications

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“…stillbirths, and more efforts will be needed to minimise this through adequate interviewer training. In many LMICs, stigmatisation, abuse and rejection are frequently experienced consequences for mothers with stillborn babies , which may discourage disclosure and reporting of stillbirths and may also influence responses provided for births that did not result in a live birth. Haws et al .…”

Section: Discussionmentioning

confidence: 99%

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Christou

Dibley

Raynes‐Greenow

2017

Tropical Med Int Health

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Objective: To systematically map data availability for stillbirths from all countries with DHS surveys to outline the limitations and challenges with using the data for understanding the determinants and causes of stillbirths, and for cross-country comparisons. Methods:We assessed data sources from the DHS program website, including published DHS (84.2%) surveys used a live birth history with a reproductive calendar, while 16 (14.0%) surveys from 12 countries did a full pregnancy history. Based on assessment of questionnaires, antenatal and delivery care information for stillbirths was only available in 15 surveys (13.2%) from 12 countries (17.1%). Data on maternal conditions/complications were captured in 17 surveys (16.0%), but only in six could these be linked to stillbirths. Data on other recognized risk factors were scarce, varying considerably across surveys. Upon further examination of datasets from surveys with maternity care data on non-live births we found incomplete capture of these data; only two surveys had adequately and completely collected them for stillbirths. Conclusion:Substantial variation exists in DHS surveys in the measurement of stillbirths, with limited scope to examine risk factors or causes. Without immediate improvements our understanding of country-specific trends and determinants for stillbirths will remain hampered, limiting the development, and prioritization of programmatic interventions to prevent these deaths.

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Section: Discussionmentioning

confidence: 99%

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Christou

Dibley

Raynes‐Greenow

2017

Tropical Med Int Health

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“…An increasing literature supports that, as for infant loss, a stillbirth can lead to poor mental and other health outcomes for both parents and the wider family, even extending to health care providers. For example, experiencing a stillbirth has been linked to ‘unspoken grief’ and a variety of psychosocial consequences such as depression, blame, shame, social isolation, problems in future pregnancies and relationship dissolution 218–220 . In Haiti, pregnancy loss associated with syphilis (which had a maternal prevalence of 6%) is so common that a myth about a werewolf sucking the blood out of the unborn fetus has developed to help women with their loss and suffering 221 .…”

Section: Quality Of Lifementioning

confidence: 99%

Syphilis

Peeling

Mabey

Kamb

et al. 2017

Nat Rev Dis Primers

493

387

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Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochetes and often imitate those of other diseases. The spirochete has a long latent period during which patients have no signs or symptoms, but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement is needed to ensure that syphilis is given high priority on the global health agenda. More investment in research is needed on the interaction between HIV and syphilis in MSM, as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.

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“…Few obstetric complications are as emotionally devastating for patients, families and clinicians as stillbirth and the grief endured by parents remains untold [1].…”

Section: Introductionmentioning

confidence: 99%

Stillbirth at a Nigerian Tertiary Hospital

Okochi¹,

Isah²,

Agida³

et al. 2018

OJOG

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Background: Despite improvements in antenatal and intrapartum care, stillbirth still remains an important, largely understudied and pregnant problem in obstetrics. Most of the stillbirths occur in the developing world and the majority of stillbirths are preventable. Objective: To determine the stillbirth rate, the identifiable risk factors and sociodemographic factors associated with stillbirths. Materials and Methods: This was a retrospective review of all deliveries conducted at UATH over a five-year period spanning from the January 2012 to December 2016. In this study, stillbirths were considered as foetal death at or after 28 weeks of gestation or a birth weight of 1000 g or more. The folders of cases that met the definition of stillbirth within the study period were retrieved and analyzed for sociodemographic factors, type of stillbirth, fetomaternal determinants of stillbirths and presumptive/identifiable risk factors for the stillbirth. Results: There were a total of 5714 deliveries within the period under review, of which 288 resulted in stillbirths giving an institutional stillbirth rate of 50.4/1000 deliveries. Out of the 288 stillbirths, 136 (47.2%) were fresh stillbirths while 152 (52.8%) were macerated. Macerated stillbirth (152, 52.8%) was slightly predominant, with obstructed labour 94 (32.6%) being responsible for most of the stillbirths. Most of the stillbirths were preterm (183, 63.5%). There were 6 congenitally malformed stillbirth foetuses and no autopsy was carried out on any of the 288 stillborn. However, majority of the parturients who had stillbirth were unemployed (137, 47.6%) and uneducated (110, 38.2%). Conclusion: The stillbirth rate within the study period appears. Complications of labour seem to be the leading risk factor for stillbirth in this study. Low socioeconomic status underscores the need to reduce factors related to social, educational, occupational and healthy inequalities in the developing world.

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Stillbirths in sub-Saharan Africa: unspoken grief

Cited by 40 publications

References 12 publications

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Syphilis

Stillbirth at a Nigerian Tertiary Hospital

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