%0 Journal Article
%T Malaria, Intestinal Helminths and Other Risk Factors for Stillbirth in Ghana
%A Nelly J. Yatich
%A Ellen Funkhouser
%A John E. Ehiri
%A Tsiri Agbenyega
%A Jonathan K. Stiles
%A Julian C. Rayner
%A Archer Turpin
%A William O. Ellis
%A Yi Jiang
%A Jonathan H. Williams
%A Evans Afriyie-Gwayu
%A Timothy Phillips
%A Pauline E. Jolly
%J Infectious Diseases in Obstetrics and Gynecology
%D 2010
%I Hindawi Publishing Corporation
%R 10.1155/2010/350763
%X Objective. The objective of the study was to assess Plasmodium/intestinal helminth infection in pregnancy and other risk factors for stillbirth in Ghana. Methods. A cross-sectional study of women presenting for delivery in two hospitals was conducted during November-December 2006. Data collected included sociodemographic information, medical and obstetric histories, and anthropometric measures. Laboratory investigations for the presence of Plasmodium falciparum and intestinal helminths, and tests for hemoglobin levels were also performed. Results. The stillbirth rate was relatively high in this population (5%). Most of the stillbirths were fresh and 24% were macerated. When compared to women with no malaria, women with malaria had increased risk of stillbirth ( , 95%£¿ ¨C9.3). Other factors associated with stillbirth were severe anemia, low serum folate concentration, past induced abortion, and history of stillbirth. Conclusion. The fact that most of the stillbirths were fresh suggests that higher quality intrapartum care could reduce stillbirth rates. 1. Introduction Of the 130 million babies born worldwide every year, approximately 4 million are stillborn [1], more than 98% of these occur in developing countries [2]. Stillbirth accounts for more than half of perinatal mortality in developing countries [3]. In Sub-Saharan Africa, stillbirths account for more than 3% of deliveries each year [2]. While countries in South-East Asia report the highest overall numbers of stillbirth, countries in Africa report the highest incidence rates per 1000 live births [4]. The average stillbirth rate in developing countries has been reported to be 26 per 1000 live births, about five times higher than in developed countries (5 per 1000) [4]. One fourth to one third of all stillbirths is estimated to take place during delivery [5, 6]. Stillbirths occurring in the intrapartum period generally have a normal appearance and are often called ¡°fresh¡± stillbirths [5]. The skin not being intact implies death more than 24 hours before delivery (antepartum), often called ¡°macerated¡± stillbirths [5]. Stillbirths have not been widely studied, have been under-reported, and rarely have been considered in attempts to improve birth outcomes in developing countries [5, 6]. There are many factors associated with stillbirth including inadequate access to obstetric care, inadequate care [7], malaria, hypertensive disease, poor nutritional status, history of stillbirth, congenital anomalies, sickle cell disease, and high burden of infectious comorbidities [5, 8¨C10]. Conceptually, infection
%U http://www.hindawi.com/journals/idog/2010/350763/