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Changing stillbirth rates: quality of care or quality of patients?
P J Iliff1, M M Bonduelle, V Gupta
1Department of Paediatrics, Medical School, University of Zimbabwe, Avondale, Harare, Zimbabwe.
Objectives:
To explain the U-shaped curve of stillbirth rates (SBR) in Harare.
Design:
A retrospective descriptive study.
Setting:
Greater Harare Maternity Unit
Subjects:
A 15pc (approx.) sample of deliveries recorded in Labour Ward registers in 1979, 1984 and 1989.
Main Outcome Measure:
Stillbirth or livebirth.
Results:
Some changes over the three years (e.g. proportion of primipara) indicate that obstetric "riskiness" of the population changed in a way which could explain the changes in SBR.
Conclusions:
However SBR's of large babies (birth weight 2,500 g to 4,499 g) increased and decreased over the years implying that changes in quality of care may also have contributed to the changes in SBR.