Prevalence of stillbirth deliveries and associated factors at Princess Christian Maternity Hospital, Sierra Leone, 2019 to 2022

Introduction: Globally, 1.9 million babies were stillborn at 28 or more weeks of gestation in 2021. In sub-Saharan Africa, the stillbirth rate is 28.7 per 1000 total births, and in Sierra Leone, it is 118.1 per 1000 total births. There is limited information on the prevalence of stillbirths, deliveries, and associated factors at Princess Christian Maternity Hospital in Sierra Leone. This study aimed to determine the prevalence of stillbirth deliveries and associated factors at Princess Christian Maternity Hospital. Methods: A retrospective cross-sectional study was conducted using a checklist to extract key variables for all stillbirths recorded from January 2019 to June 2022 at Princess Christian Maternity Hospital (PCMH), the main tertiary teaching hospital of Sierra Leone. Data was collected on the mother's age, marital status, gravidity, parity, mode of delivery and type of delivery, sex of the baby, the status of stillbirth, and birth weight. The collected data were entered into Microsoft Excel 2016 and exported to Epi info version 7 for analysis. Multivariate logistic regression was used to identify factors associated with stillbirth. Results: A total of 11,063 deliveries were recorded during the study period, of which 1,097 (10%) were stillbirths, and the average rate was 99 per 1000 total births. Descriptive analysis showed that multiparous women, 619 (56.4%), accounted for more stillbirth deliveries. Antepartum stillbirth, 912 (83.1%), accounted for the highest. Women within the age group 30 – 39 years (aOR= 0.5, 95% CI: 0.30 – 0.86), Antepartum hemorrhage (APH) aOR=6.2, 95% CI: 4.55 – 8.42) and low birth weight babies (aOR=3.7, 95% CI: 3.18 – 4.29) were the factors independently associated with stillbirth deliveries. In 2019, before the COVID-19 pandemic, the stillbirth rate was 98.4 per 1,000 total births. In 2020, during the pandemic, the rate increased to 103.9 per 1,000 total births. However, by 2022, the stillbirth rate had declined to 96.0 per 1,000 total births. Conclusion: The prevalence of stillbirths in this study was high. Antepartum haemorrhage and low birth weight were the factors associated with stillbirth deliveries. However, women in the advanced maternal age group (30-39 years) were protected. We recommend that the Directorate of Maternal and Child Health enhance access to antenatal care, transportation services, and intrapartum care, targeting mothers under 30 years old. Furthermore, since most of the stillbirths were unexplained, we recommend conducting further prospective studies.