Stillbirths in Jordan: rate, causes, and preventability

  • Maternal and child health
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Background:
Many countries in the region including Jordan do not include stillbirth in their vital statistics reporting system. There are no available data in Jordan about rates and common causes of stillbirth to suggest solutions. This study aimed to determine the stillbirth rate in Jordan and determine the leading causes of stillbirths. Analyzing the stillbirth data from a large sample size of Jordanian women would be very valuable for planning the resources and improving the services.

Methods:
The data from the national study of perinatal mortality in Jordan were analyzed. A total of 21,980 women who delivered at a gestational age ≥ 20 weeks in any of the 18 selected hospitals during the study period (March 2011-April 2012) were analyzed. The stillbirth rate was calculated as the number of stillbirths per 1,000 total births. The deaths were also classified according to NICE classification system.

Results:
The rates of stillbirths were 11.6/1,000 total births born after 20 weeks of gestation, 11.2 /1,000 total births born ≥22 weeks of gestation, 10.6/1,000 total births born ≥24 weeks of gestation, and 9.0/1,000 total births born ≥28 weeks of gestation. According to NICE classification, the main causes of stillbirths were maternal diseases (19.5%), unexplained immaturity (18.8%), congenital anomalies (17.6%), unexplained antepartum stillbirths (17.6%), obstetric complications (8.4%), placental abruption (5.7%) and multiple births (5%). The expert Panel judged that 34.5% of all fetal deaths were preventable and 30.3% were possibly preventable with optimal care.

Conclusion:
This study highlighted stillbirth risks in Jordan, which could encourage maternal-infant health care providers, other researchers, policymakers, and stakeholders to implement solutions and to develop a feasible intervention. Antenatal care can potentially serve as a platform to deliver interventions to improve maternal nutrition, screen for and treat risk factors, and encourage skilled attendance at birth.

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