Prevalence and factors associated with stillbirth in mothers delivered by cesarean section at Orotta National Referral Maternity Hospital: case-control study

Stillbirth is a growing public health issue worldwide and accounts for most perinatal death. As the prevalence and factors associated with stillbirth in mothers delivered by cesarean section were not determined in Eritrea, this study aimed to identify factors associated with stillbirth at Orotta National Referral Maternity Hospital. It was a hospital-based retrospective case-control study. All mothers delivered by caesarean section who had stillbirths during the study period were included as cases, and three successive live births per case were considered as controls. Data were collected using a structured data extraction tool, and univariable and multivariable analyses were done to identify the association of stillbirth with the outcome variables, and p < 0.05 was considered significant. A total of 2,865 mothers delivered by cesarean section during the study period, and 380 sampled charts of mothers were analyzed, with a case-to-control ratio of 1:3. The prevalence of stillbirth among cesarean section deliveries was 3.3%. Mothers referred from other region of residence (AOR: 2.0; 95%CI: 1.10–3.63; p = 0.02), delivered with the indication of previous cesarean section (AOR:3.13; 95%CI: 1.20–8.14; p = 0.02), newborns delivered by emergency cesarean section (AOR:5.24; 95%CI: 1.95–14.04; P < 0.001) and male gender of newborns (AOR: 3.23; 95% CI: 1.82–5.74, p < 0.001) were factors appear to be markers of high-risk pregnancies. Our study indicates that referrals from other region of residence, emergency cesarean section and male sex were found to be the factors appear to be markers of high-risk pregnancies. Focusing on causes requiring emergency caesarean section during antenatal care, empowering referral systems, appropriate intrapartum monitoring, and early risk assessment for complications is paramount for early intervention and prevention of stillbirth.