EPIDEMIOLOGY OF STILLBIRTHS AND CONGENITAL MALFORMATIONS IN IBADAN, NIGERIA: A HOSPITAL BASED STUDY

Abstract

The study consisted of retrospective analysis of stillbirths and congenital malformations over a three year period 1978 to 1980 in two big hospitals - University College Hospital (UGH) and Oluyoro Catholic Hospital both in Ibadan, and a descriptive epidemiological study based on prospective interview of a systematically selected sample of pregnant women attending the antenatal clinics of UCH and St Mary's Catholic Hospital, Eleta, (Eleta) Ibadan. An overall stillbirth rate of 28.4/1000 total births and an overall congenital malformation rate of 13.3/1000 total births were recorded in Ibadan during the period of study, 1985/86. A high proportion of fresh stillbirths with no visible congenital malformations were observed, particularly in UCH. The commonest types of congenital malformations observed in this series were bony defects, particularly polydactyly which overall, had an incidence of 4.7/1000 total births. This was followed by equinovarus/valgus and achondroplasia 1.1/1000 total births; central nervous system malformations - anencephaly 0.94/1000, spina bifida 0.16/1000, hydrocephalus 0.47/1000 and

meningomyelocoele 0.16/1000 total births; congenital heart defects 0.47/1000 total births; gastrointestinal malformations, cleft lip and cleft palate, tracheo-oesophageal fistula and oesophageal atresia, 0.16/1000 total births; while facial malformations (micro-ophthalmia) recorded 0.31/1000 total births. The study revealed that inherent/genetic factor such as maternal age was the most significant factor associated with the occurrence of macerated stillbirths and congenital malformations, followed to some significant extent by maternal parity, while the occurrence of fresh still births was influenced more by environmental factors. Irregular attendance at antenatal clinic, maternal under-nutrition and maternal anaemia were also found to increase the risk of stillbirths and congenital malformations. The study also revealed that there is a remarkable degree of drug abuse - indiscriminate drug usage (prescribed and unprescribed), among the pregnant women in Ibadan. Serological analysis of an postnatal and cord blood samples showed a very high prevalence of teratogenic. Infections namely, Rubella, Cytomegalovirus, Toxoplasmosis and Hepatitis B antigen in the Nigerian environment. All the samples examined were, however, negative for Human immuno-deficiency virus (AIDS Virus).