A Ten Year Analysis of Intrauterine Fetal Deaths: An Age-Matched Case Control Study at a General Hospital in Sub-Saharan Africa

Introduction: Intrauterine Foetal Death (IUFD) is one of the final pathways of adverse pregnancy outcome. It is a public health problem with increasing prevalence across diverse populations, especially in Sub-Saharan Africa.

Objective: This population-based study was aimed at determining the rate and risk factors for IUFD in a secondary-level medical center in southern Nigeria Methodology: This was a retrospective age-matched case control study carried out among 402 women who were on admission in the maternity ward of General Hospital Anua, Akwa Ibom State, Nigeria between January 2006 and December 2017. They were selected using incidental non-probability sampling method from the hospital records. Data was analyzed using Statistical Package for the Social Sciences, version 23.

Results: Average maternal age was 24.26 years among the case and 23.56 among the control participants. The age group 18-29 had the most participants (49.8%). The risk of intrauterine foetal death was statistically significant when assoiated with adverse perinatal outcome[OR = 1.05 (95%CI: 1.01-1.09, p value < 0.001)] ; malpresentation [OR = 0.16 (95%CI: 0.12-0.27, p value < 0.001)]; previous caesarean section[OR = 2.06 (95%CI: 1.31-2.61, p value < 0.001)] ; fetal macrosomia[OR = 3.71 (95%CI: 3.06-4.91, p value < 0.001)]; preeclampsia [OR = 1.34 (95%CI: 0.71-1.69, p value < 0.001)] ; ecclampsia [OR = 2.96 (95%CI: 1.92-3.61, p value < 0.001)] ; oligohydramnios[OR = 1.54 (95%CI: 1.12-1.94, p value < 0.001)] ; polyhydramnios [OR = 1.49 (95%CI: 1.34-1.76, p value < 0.001)] ;placenta abruption[OR = 3.84 (95%CI: 1.71-5.61, p value < 0.001)] ; placenta praevia[OR = 1.05 (95%CI: 1.62-2.19, p value < 0.001)] ; cord prolapse[OR = 4.69 (95%CI: 2.17-6.19, p value < 0.001)] ; true knot [OR = 3.16 (95%CI: 2.89-4.61, p value < 0.001)] ;and gestational diabetes [OR = 1.01 (95%CI: 1.94-2.05, p value < 0.001)].

Conclusion: Intrauterine fetal demise is associated with several risk factors which can be maternal, fetal or placental. This underscores the need for adequate antenatal surveillance, birth preparedness and complication readiness to avert the misfortune.