Trend of stillbirth and associated factors among women who gave birth at a specialized hospital in northern Ethiopia: A 10-year record review
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Published
Oct 30, 2025
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Gebrekiros Gebremichael Meles
https://orcid.org/0000-0001-6563-0001
Yibrah Berhe
Zewde Abraha
Wegen Beyene
Yonas Moges
Mache Tsadik
Tsadkan Gebremeskel Haile
Gebreslassie Gebremariam Berhe
Yemane Amare
Awol Yemane
Hale Teka
Liya Mamo
Medhanie Gebreslassie
Kidanemariam Alem
Kebede Embaye
Haftom Temesgen Abebe
https://orcid.org/0000-0001-6563-0001
Yibrah Berhe
Zewde Abraha
Wegen Beyene
Yonas Moges
Mache Tsadik
Tsadkan Gebremeskel Haile
Gebreslassie Gebremariam Berhe
Yemane Amare
Awol Yemane
Hale Teka
Liya Mamo
Medhanie Gebreslassie
Kidanemariam Alem
Kebede Embaye
Haftom Temesgen Abebe
Abstract
Background: Stillbirths are the most significant indicators of maternal and infant health care. Even with the numerous attempts by international organizations to lower the number of stillbirths, low- and middle-income countries, especially Ethiopia, face formidable obstacles in tackling this problem. Therefore, this study aimed to estimate the stillbirth rate and trends among mothers who delivered at Ayder Comprehensive Specialized Hospital, Northern Ethiopia.
Methods: A retrospective analysis of birth registries was conducted at Ayder Comprehensive Specialized Hospital, which is located in Tigray, Northern Ethiopia. We prepared a checklist to extract the available information from the birth records from July 2011 to August 2021. We collected the data via an open data kit tool. A binary logistic regression model was used to identify the factors associated with stillbirth, and an odds ratio with a 95% confidence interval was used to assess the strength of the association.
Results: Over the course of the 10-year study period, the researchers discovered that there were 51.3 stillbirths for every 1000 live births (95% CI: 48.7-54.0). A stillbirth from a mother aged 36-50 years (AOR=1.97, 95% CI: 1.56-2.48), an unstable maternal health status (AOR=100.1, 95% CI: 71.38-140.38), a male newborn (AOR=1.25, 95% CI: 1.09-1.44), low and very low birth weights (AOR=29.77, 95% CI: 24.46-36.25), and a singleton birth (AOR=0.43, 95% CI: 0.32-0.58) were the factors that were independently associated with stillbirth.
Conclusion: The stillbirth rate was alarmingly higher in this study, indicating that immediate attention is needed. Interventions that address low birth weight, advanced maternal age, and maternal health status should be prioritized in the fight to lower the stillbirth rate.
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Keywords
stillbirth, trend, Ayder Comprehensive Specialized Hospital
References
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14. Blencowe H CS, Jassir FB, Say L, Chou D, Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: A systematic analysis. Lancet Glob Health. 2016;4(2):e98–108.
15. https://ayder.info/index.php/about-us, accessed on Nov.23, 2023 [
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20. Gilano G, Hailegebreal S, Seboka BT. Determinants and spatial distribution of institutional delivery in Ethiopia?: evidence from Ethiopian Mini Demographic and Health Surveys 2019. Arch Public Heal [Internet]. BioMed Central; 2022;1–12. Available from: https://doi.org/10.1186/s13690-022-00825-2.
21. Chan GJ, Goddard FGB, Hunegnaw BM, Mohammed Y, Hunegnaw M. Estimates of Stillbirths , Neonatal Mortality , and Medically Vulnerable Live Births in Amhara , Ethiopia. 2022;5(6):1–11. .
22. Jena BH, Biks GA, Gelaye KA, Gete YK. Magnitude and trend of perinatal mortality and its relationship with interpregnancy interval in Ethiopia: A systematic review and meta-analysis. BMC Pregnancy Childbirth. BMC Pregnancy and Childbirth; 2020;20(1):1–13. .
23. Anyichie NE, Nwagu EN. Prevalence and maternal sociodemographic factors associated with stillbirth in health facilities in Anambra, south?east Nigeria. Afr Health Sci. 2019;19(4):3055–62. .
24. Berhan Y, Berhan A. Perinatal mortality trends in Ethiopia. Ethiop J Health Sci. 2014;24:29–40. .
25. Gwako GN, Were F, Obimbo MM, Kinuthia J, Gachuno OW, Gichangi PB. Association between utilization and quality of antenatal care with stillbirths in four tertiary hospitals in a low-income urban setting. 2023;100(4):676–83.
26. Tesema GA, Gezie LD, Nigatu SG. Spatial distribution of stillbirth and associated factors in Ethiopia?: a spatial and multilevel analysis. 2020; .
27. Goba GK, Legesse AY, Whelan A, Divelbess K, Cavanaug E, Mohammednur SA, et al. Prevalence of Stillbirth in Ayder Comprehensive Specialized Hospital, North Ethiopia: a Descriptive Retrospective Study. Ethiop J Reprod Heal. 2019;11(3):26–32. .
28. Berhie KA, Gebresilassie HG. Logistic regression analysis on the determinants of stillbirth in Ethiopia. Matern Heal Neonatol Perinatol [Internet]. Maternal Health, Neonatology and Perinatology; 2016;2(1):1–10. Available from: http://dx.doi.org/10.1186/s40748-016-0038-5.
29. Lakew D, Tesfaye D, Mekonnen H. Determinants of stillbirth among women deliveries at Amhara region, Ethiopia. BMC Pregnancy Childbirth. BMC Pregnancy and Childbirth; 2017;17(1):1–7. .
30. Hadar E, Melamed N, Sharon-Weiner M, Hazan S, Rabinerson D, Glezerman M, Yogev Y. The association between stillbirth and fetal gender. J Matern Fetal Neonatal Med. 2012 Feb;25(2):158-61. doi: 10.3109/14767058.2011.565838. Epub 2011 Mar 31. PMID: 21449834.
31. Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM. Does fetal sex affect pregnancy outcome? Gend Med. 2007 Mar;4(1):19-30. doi: 10.1016/s1550-8579(07)80004-0. PMID: 17584623.
32. Mondal D, Galloway TS, Bailey TC, Mathews F. Elevated risk of stillbirth in males?: systematic review and meta-analysis of more than 30 million births. 2014;1–11.
33. Welegebriel TK, Dadi TL, Mihrete KM. Determinants of stillbirth in Bonga General and Mizan Tepi University Teaching Hospitals southwestern Ethiopia, 2016: A case?control study. BMC Res Notes [Internet]. BioMed Central; 2017;10(1):1–5. Available from: https://doi.org/10.1186/s13104-017-3058-y.
34. Abebe H, Shitu S, Workye H, Mose A. Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case?control study. PLoS One [Internet]. 2021;16(5 May):1–13. Available from: http://dx.doi.org/10.1371/journal.pone.0249865.
35. Tesfay N, Legesse F, Kebede M and Woldeyohannes F (2022) Determinants of stillbirth among reviewed perinatal deaths in Ethiopia. Front. Pediatr. 10:1030981. doi: 10.3389/fped.2022.1030981.
36. Madrid L, Alemu A, Seale AC, Oundo J, Tesfaye T, Marami D, et al. Articles Causes of stillbirth and death among children younger than 5 years in eastern Hararghe , Ethiopia?: a population-based postmortem study. :1032–40.
2. Berhie KA, Gebresilassie HG. Logistic regression analysis on the determinants of stillbirth in Ethiopia. [Internet. Matern Heal Neonatol Perinatol 2016;2(1):1-10.
3. UNICEF. Never Forgotten: The situation of still birtharround the globe. 2023.
4. Admasu K, Haile-Mariam A, Bailey P. Indicators for availability, utilization, and quality of emergency obstetric care in Ethiopia, 2008. Int J Gynecol Obstet. 2011;115(1):101–5.
5. Bernis L, Kinney MV, Stones W, ten Hoope-Bender P, Vivio D, Leisher SH, et al. Stillbirths: ending preventable deaths by 2030. Lancet Glob Health. 2016;387(10019):703–16.
6. Hug L, You D, Blencowe H, et al; UN Interagency Group for Child Mortality Estimation and Its Core Stillbirth Estimation Group. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021;398(10302):772-785. doi:10.1016/S0140-6736(21)01112-0).
7. UNIGME. A neglected tragedy: the global burden of stillbirths. New York: United Nations Children’s Fund. 2020.
8. Jena BH, Biks GA, Gelaye KA, Gete YK. Magnitude and trend of perinatal mortality and its relationship with interpregnancy interval in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):1–13.
9. Anyichie NE, Nwagu EN. Prevalence and maternal sociodemographic factors associated with stillbirth in health facilities in Anambra, south?east Nigeria. . Afr Health Sci. 2019;19(4):3055–62.
10. Goldenberg RL, Muhe L, Saleem S, Dhaded S, Goudar SS, Patterson J, et al. Criteria for assigning cause of death for stillbirths and neonatal deaths in research studies in low-middle income countries. J Matern Neonatal Med. 2019;32(11):1915–23.
11. Lindtjørn B, Mitike D, Zidda Z, Yaya Y. Reducing stillbirths in Ethiopia: Results of an intervention programme. PLoS One. 2018;13(5):1-11.
12. Berhan Y, Berhan A. . Perinatal mortality trends in Ethiopia. Ethiop J Health Sci 2014;24:29–40
13. Welegebriel TK, Dadi TL, Mihrete KM. Determinants of stillbirth in Bonga General and Mizan Tepi University Teaching Hospitals southwestern Ethiopia. A case?control study. BMC Res Notes. 2017;10(1):1–5.
14. Blencowe H CS, Jassir FB, Say L, Chou D, Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: A systematic analysis. Lancet Glob Health. 2016;4(2):e98–108.
15. https://ayder.info/index.php/about-us, accessed on Nov.23, 2023 [
16. https://ayder.info/index.php/about-us?view=article&id=69:background&catid=47 [
17. Mengistu S, Debella A, Mulatu T, Mesfin F. Stillbirth and Associated Factors Among Women Who Gave Birth at Hiwot Fana Specialized University. 2022;10(May):1–7. .
18. WHO report on Stillbirth. Accessed on December 30 2023: https://www.wh.int/health-topics/stillbirth#tab=tab_1
19. WHO Africa region News report. Fewer maternal deaths and stillbirths in Ethiopia?: improving quality of care is paying off. (March 2019). Available from: https://www.afro.who.int/news/fewer-maternal-deaths-and-stillbirths-ethiopia-improving-quality-care-paying.
20. Gilano G, Hailegebreal S, Seboka BT. Determinants and spatial distribution of institutional delivery in Ethiopia?: evidence from Ethiopian Mini Demographic and Health Surveys 2019. Arch Public Heal [Internet]. BioMed Central; 2022;1–12. Available from: https://doi.org/10.1186/s13690-022-00825-2.
21. Chan GJ, Goddard FGB, Hunegnaw BM, Mohammed Y, Hunegnaw M. Estimates of Stillbirths , Neonatal Mortality , and Medically Vulnerable Live Births in Amhara , Ethiopia. 2022;5(6):1–11. .
22. Jena BH, Biks GA, Gelaye KA, Gete YK. Magnitude and trend of perinatal mortality and its relationship with interpregnancy interval in Ethiopia: A systematic review and meta-analysis. BMC Pregnancy Childbirth. BMC Pregnancy and Childbirth; 2020;20(1):1–13. .
23. Anyichie NE, Nwagu EN. Prevalence and maternal sociodemographic factors associated with stillbirth in health facilities in Anambra, south?east Nigeria. Afr Health Sci. 2019;19(4):3055–62. .
24. Berhan Y, Berhan A. Perinatal mortality trends in Ethiopia. Ethiop J Health Sci. 2014;24:29–40. .
25. Gwako GN, Were F, Obimbo MM, Kinuthia J, Gachuno OW, Gichangi PB. Association between utilization and quality of antenatal care with stillbirths in four tertiary hospitals in a low-income urban setting. 2023;100(4):676–83.
26. Tesema GA, Gezie LD, Nigatu SG. Spatial distribution of stillbirth and associated factors in Ethiopia?: a spatial and multilevel analysis. 2020; .
27. Goba GK, Legesse AY, Whelan A, Divelbess K, Cavanaug E, Mohammednur SA, et al. Prevalence of Stillbirth in Ayder Comprehensive Specialized Hospital, North Ethiopia: a Descriptive Retrospective Study. Ethiop J Reprod Heal. 2019;11(3):26–32. .
28. Berhie KA, Gebresilassie HG. Logistic regression analysis on the determinants of stillbirth in Ethiopia. Matern Heal Neonatol Perinatol [Internet]. Maternal Health, Neonatology and Perinatology; 2016;2(1):1–10. Available from: http://dx.doi.org/10.1186/s40748-016-0038-5.
29. Lakew D, Tesfaye D, Mekonnen H. Determinants of stillbirth among women deliveries at Amhara region, Ethiopia. BMC Pregnancy Childbirth. BMC Pregnancy and Childbirth; 2017;17(1):1–7. .
30. Hadar E, Melamed N, Sharon-Weiner M, Hazan S, Rabinerson D, Glezerman M, Yogev Y. The association between stillbirth and fetal gender. J Matern Fetal Neonatal Med. 2012 Feb;25(2):158-61. doi: 10.3109/14767058.2011.565838. Epub 2011 Mar 31. PMID: 21449834.
31. Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM. Does fetal sex affect pregnancy outcome? Gend Med. 2007 Mar;4(1):19-30. doi: 10.1016/s1550-8579(07)80004-0. PMID: 17584623.
32. Mondal D, Galloway TS, Bailey TC, Mathews F. Elevated risk of stillbirth in males?: systematic review and meta-analysis of more than 30 million births. 2014;1–11.
33. Welegebriel TK, Dadi TL, Mihrete KM. Determinants of stillbirth in Bonga General and Mizan Tepi University Teaching Hospitals southwestern Ethiopia, 2016: A case?control study. BMC Res Notes [Internet]. BioMed Central; 2017;10(1):1–5. Available from: https://doi.org/10.1186/s13104-017-3058-y.
34. Abebe H, Shitu S, Workye H, Mose A. Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case?control study. PLoS One [Internet]. 2021;16(5 May):1–13. Available from: http://dx.doi.org/10.1371/journal.pone.0249865.
35. Tesfay N, Legesse F, Kebede M and Woldeyohannes F (2022) Determinants of stillbirth among reviewed perinatal deaths in Ethiopia. Front. Pediatr. 10:1030981. doi: 10.3389/fped.2022.1030981.
36. Madrid L, Alemu A, Seale AC, Oundo J, Tesfaye T, Marami D, et al. Articles Causes of stillbirth and death among children younger than 5 years in eastern Hararghe , Ethiopia?: a population-based postmortem study. :1032–40.
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