Stillbirths in Cameroon: an analysis of the 1998-2011 demographic and health surveys.

BACKGROUND: Many countries, including Cameroon, have found it challenging to estimate stillbirths, as there are limited available reports accurately. This analysis aimed to assess stillbirth rates and identify risk factors for stillbirth in Cameroon using successive Demographic and Health Survey data. METHODS: We conducted a cross-sectional analysis of data collected during the Demographic and Health Surveys of 1998, 2004, and 2011. Data were analyzed using SPSS 20.0. Logistic regressions were used to identify factors associated with stillbirth through odds ratios (ORs) at 95% confidence intervals (CI). Results were considered statistically significant at p-value less than 0.05. RESULTS: The crude stillbirth rate was 21.4 per 1,000 births in 2004 and 24 per 1,000 births in 2011, with respective standard errors of 1.8 and 1.3. The stillbirth rate increased with the mother's age (p < 0.001). The stillbirth rate reduction was prolonged between 1998 and 2011, with an annual reduction rate of 1.6%. The study observed that residing in rural areas, low socioeconomic status, and low level of education were risk factors associated with stillbirths. CONCLUSION: Cameroon's stillbirth rate remains very high, with a slow reduction rate over the last 20 years. Although some efforts are ongoing, there is still a long way forward to bend the curve for stillbirths in Cameroon; supplementary strategies must be designed and implemented, especially among rural women, the poor, and the less educated.

[Factors associated to the coiling of umbilical cord: case-control study conducted in three hospitals in Yaoundé]. / Facteurs associés aux circulaires du cordon: étude cas-témoin dans trois hôpitaux de Yaoundé.

INTRODUCTION: The coiling of umbilical cord is the winding of the umbilical cord around a part of the fetal body once or several times. It is the most common abnormality of the cord, its prevalence varies according to the authors from 5.7% to 35.1%. In 2011, the rate of perinatal mortality due to the coiling of umbilical cord in Cameroun was 6.1%. However factors associated to it are little known in our context. Our purpose was to determine factors associated to the coiling of umbilical cord in three hospitals in Yaoundé. METHODS: We conducted an analytical case-control study in the Maternity Unit at the Central Hospital of Yaoundé, the University Teaching Hospital of Yaoundé and the Social and Health Nkoldongo Animation Center over a period of 4 months. The study-group composed of newborns with coiling of umbilical cord was compared with two control groups (newborns without coiling of umbilical cord). All the fetuses were cephalic at delivery (singleton pregnancies at term). Pre-established technical data sheets were filled with data collected and analyzed based on the Microsoft Excel 2017 and SPSS software Version 23. The parameters used for the analysis were the average age, standard deviation and frequency, the raw odds ratio (OR) and/or adjusted (aOR) with their 95% confidence interval. P was considered significant for any value less than 5. RESULTS: Out of a total of 3,300 deliveries, 500 newborns (15.15%) had coiling of umbilical cord. All the coils were around the neck. We retained and studied 136 newborns with coiling of umbilical cord (study group) vs 272 newborns without coiling of umbilical cord (control group). Factors independently associated with coiling were non editable: length of the cord = 70cm (ORa = 32 CI = 17.5-35 p = 0.02), male sex (ORa = 67.09 CI = 22.31 - 97.46 P = 0.001), APGAR score 5th minute <7 (ORa =76.98 CI = 2.19 - 27.05 P=0.017) and modifiable factors were gestational age = 42WA (ORa = 15.15 CI = 6.14-18.2 P = 0.001). CONCLUSION: The coiling of umbilical cord is a frequent cord abnormality. We suggest to the decision-makers to increase awareness among health workers and the population on the importance of ultrasound scan of the third trimester in order to detect coiling of umbilical cord and implement appropriate manage newborns. Clinicians should avoid as much as possible post-term pregnancy.

Maternal mortality in Cameroon: a university teaching hospital report.

More than 550,000 women die yearly from pregnancy-related causes. Fifty percent (50%) of the world estimate of maternal deaths occur in sub-Saharan Africa alone. There is insufficient information on the risk factors of maternal mortality in Cameroon. This study aimed at establishing causes and risk factors of maternal mortality. This was a case-control study from 1st January, 2006 to 31st December, 2010 after National Ethical Committee Approval. Cases were maternal deaths; controls were women who delivered normally. Maternal deaths were obtained from the delivery room registers and in-patient registers. Controls for each case were two normal deliveries following identified maternal deaths on the same day. Variables considered were socio-demographic and reproductive health characteristics. Epi Info 3.5.1 was used for analysis. The mean MMR was 287.5/100,000 live births. Causes of deaths were: postpartum hemorrhage (229.2%), unsafe abortion (25%), ectopic pregnancy (12.5%), hypertension in pregnancy (8.3%), malaria (8.3%), anemia (8.3%), heart disease (4.2%), and pneumonia (4.2%), and placenta praevia (4.2%). Ages ranged from 18 to 41 years, with a mean of 27.7 ± 5.14 years. Lack of antenatal care was a risk factor for maternal death (OR=78.33; CI: (8.66- 1802.51)). The mean MMR from 2006 to 2010 was 287.5/100,000 live births. Most of the causes of maternal deaths were preventable. Lack of antenatal care was a risk factor for maternal mortality. Key words: Maternal mortality, causes, risk factors, Cameroon.