Incidence and probable risk factors of stillbirth in Maternity Teaching Hospital in Erbil city

* Kirkuk Health Directorate , Kirkuk, Iraq. ** Department of gynecology, college of medicine, Hawler Medical University, Erbil, Iraq. Introduction The World Health Organization (WHO) and the international classification of diseases (ICD) defined stillbirth as the death of a fetus that has reached a birth weight of 500g, or if birth weight is unavailable, a gestational age of 22 weeks or crownto-heel length of 25 cm. Stillbirth is classified as fresh stillbirth when the baby born with an intact skin suggesting that the death occur during labour (less than 12 hours before delivery), and macerated stillbirth, when there is signs of degeneration (peeling of skin, red serous effusions in the chest and abdomen due to hemoglobin staining) suggesting the death occur more than 12–24 hours before labour. About 3.2 million stillbirths occur worldwide every year, 98% of these in the developing world, 5/1000 total deliveries in the developed world, 25-32/ 1000 total deliveries in the developing world. Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. It is important to recognize that the loss of a fetus during pregnancy is a cause of major protracted psychological morbidity for some women and their families. Stillbirths are both common and devastating, and in developed countries, about one third has been shown to be of unknown or unexplained origin. There are several factors associated with fetal loss. Some of these have a clear causal link such as an abruption or a cord event, while others may contribute indirectly to fetal loss such as obesity. Some losses may be associated Background and objective: Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. The aim of this study was to determine the prevalence, probable risk factors and association of stillbirth with different maternal variables in Erbil Maternity Teaching Hospital. Methods: A cross-sectional design was used to determine the prevalence of stillbirth and a case control design was used to determine the probable risk factors and demographic characteristics of women with stillbirth in Maternity Teaching Hospital in Erbil city, Kurdistan region, Iraq, from April 1, to December 31, 2011.Three hundred seventy nine women having stillbirth were regarded as cases while 758 women delivering alive newborns were regarded as control group. Results: The prevalence of stillbirth during the period of the study was 20.4 per1000 total births. Macerated stillbirth was about four times higher than the fresh stillbirth. There were statistically significant differences between the cases and controls in relation to: maternal age (≥ 35 years), level of education, history of antenatal care visits, parity, medical diseases of the mother, congenital anomalies of the newborn, and history of previous stillbirth. In 65.4% of cases the probable cause of death was unexplained. Conclusion: The prevalence of stillbirth in the Maternity Teaching Hospital in Erbil is high in comparison to the rate in other countries. This could be due to high level of deliveries per day and lack of good follow up of patients during labour.