{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:01:26Z","timestamp":1772136086906,"version":"3.50.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The Greater Accra Region (GAR) of Ghana records 2000 stillbirths annually and 40% of them occur intrapartum. An understanding of the contributing factors will facilitate the development of preventive strategies to reduce the huge numbers of intrapartum stillbirths. This study identified determinants of intrapartum stillbirths in GAR. A retrospective 1:2 unmatched case\u2013control study was conducted in six public hospitals in the Greater Accra Region of Ghana. A multivariable binary logistic regression model was used to quantify the effect of exposures on intrapartum stillbirth. The area under the receiver operating characteristics curve and the Brier scores were used to screen potential risk factors and assess the predictive performance of the regression models. The following maternal factors increased the odds of intrapartum stillbirths: pregnancy-induced hypertension (PIH) [adjusted Odds Ratio; aOR\u2009=\u20093.72, 95% CI:1.71\u20138.10,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001]; antepartum haemorrhage (APH) [aOR\u2009=\u20093.28, 95% CI: 1.33\u20138.10,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05] and premature rupture of membranes (PROM) [aOR\u2009=\u20093.36, 95% CI: 1.20\u20139.40,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05]. Improved management of PIH, APH, PROM, and preterm delivery will reduce intrapartum stillbirth. Hospitals should improve on the quality of monitoring women during labor. Auditing of intrapartum stillbirths should be mandatory for all hospitals and Ghana Health Service should include fetal autopsy in stillbirth auditing to identify other causes of fetal deaths. Interventions to reduce intrapartum stillbirth must combine maternal, fetal and service delivery factors to make them effective.\n                  <\/jats:p>","DOI":"10.1038\/s41598-022-27088-9","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T13:03:59Z","timestamp":1674047039000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Modeling clinical and non-clinical determinants of intrapartum stillbirths in singletons in six public hospitals in the Greater Accra Region of Ghana: a case\u2013control study"],"prefix":"10.1038","volume":"13","author":[{"given":"Linda","family":"Vanotoo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duah","family":"Dwomoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amos","family":"Laar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes Millicent","family":"Kotoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Adanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"issue":"Suppl 1","key":"27088_CR1","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1186\/1471-2393-9-s1-s4","volume":"9","author":"EV Menezes","year":"2009","unstructured":"Menezes, E. V. et al. Reducing stillbirths: Prevention and management of medical disorders and infections during pregnancy. BMC Pregnancy Childbirth 9(Suppl 1), S4. https:\/\/doi.org\/10.1186\/1471-2393-9-s1-s4 (2009).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR2","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/1471-2393-14-90","volume":"14","author":"AA Adane","year":"2014","unstructured":"Adane, A. A., Ayele, T. A., Ararsa, L. G., Bitew, B. D. & Zeleke, B. M. Adverse birth outcomes among deliveries at Gondar University Hospital Northwest Ethiopia. BMC Pregnancy Childbirth 14, 90. https:\/\/doi.org\/10.1186\/1471-2393-14-90 (2014).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR3","doi-asserted-by":"publisher","first-page":"635","DOI":"10.12998\/wjcc.v3.i7.635","volume":"3","author":"AOA Adekanbi","year":"2015","unstructured":"Adekanbi, A. O. A., Olayemi, O. O., Fawole, A. O. & Afolabi, K. A. Scourge of intra-partum foetal death in Sub-Saharan Africa. World J. Clin. Cases WJCC 3, 635\u2013639. https:\/\/doi.org\/10.12998\/wjcc.v3.i7.635 (2015).","journal-title":"World J. Clin. Cases WJCC"},{"key":"27088_CR4","first-page":"772","volume":"398","author":"L Hug","year":"2021","unstructured":"Hug, L. et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: A systematic assessment. Lancet Glob. Health 398, 772\u2013785 (2021).","journal-title":"Lancet Glob. Health"},{"key":"27088_CR5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1742-4755-11-22","volume":"11","author":"G Abeje","year":"2014","unstructured":"Abeje, G., Azage, M. & Setegn, T. Factors associated with institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: A community based cross sectional study. Reprod. Health 11, 22. https:\/\/doi.org\/10.1186\/1742-4755-11-22 (2014).","journal-title":"Reprod. Health"},{"key":"27088_CR6","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/1471-2393-9-s1-s2","volume":"9","author":"JE Lawn","year":"2009","unstructured":"Lawn, J. E. et al. 32 million stillbirths: Epidemiology and overview of the evidence review. BMC Pregnancy Childbirth 9, S2. https:\/\/doi.org\/10.1186\/1471-2393-9-s1-s2 (2009).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR7","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1016\/j.ijgo.2009.07.016","volume":"107","author":"JE Lawn","year":"2009","unstructured":"Lawn, J. E. et al. Two million intrapartum-related stillbirths and neonatal deaths: Where, why, and what can be done?. Int. J. Gynecol. Obstet. 107, S5\u2013S19. https:\/\/doi.org\/10.1016\/j.ijgo.2009.07.016 (2009).","journal-title":"Int. J. Gynecol. Obstet."},{"key":"27088_CR8","unstructured":"Ghana Health Service (ed Ghana Health Service PPMED) (Ghana Health Service, Accra, Ghana, 2017)."},{"key":"27088_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2393-12-139","volume":"12","author":"BT Mmbaga","year":"2012","unstructured":"Mmbaga, B. T. et al. Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000\u20132010: A registry based study. BMC Pregnancy Childbirth 12, 1\u20139 (2012).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR10","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1471-2393-13-12","volume":"13","author":"A Gordon","year":"2013","unstructured":"Gordon, A., Raynes-Greenow, C., McGeechan, K., Morris, J. & Jeffery, H. Risk factors for antepartum stillbirth and the influence of maternal age in New South Wales Australia: A population based study. BMC Pregnancy Childbirth 13, 12. https:\/\/doi.org\/10.1186\/1471-2393-13-12 (2013).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR11","doi-asserted-by":"publisher","first-page":"186867","DOI":"10.1155\/2010\/186867","volume":"2010","author":"A Jammeh","year":"2010","unstructured":"Jammeh, A., Vangen, S. & Sundby, J. Stillbirths in rural hospitals in the gambia: A cross-sectional retrospective study. Obstet. Gynecol. Int. 2010, 186867 (2010).","journal-title":"Obstet. Gynecol. Int."},{"key":"27088_CR12","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/ppe.12026","volume":"27","author":"S Nahar","year":"2013","unstructured":"Nahar, S., Rahman, A. & Nasreen, H. E. Factors influencing stillbirth in Bangladesh: A case\u2013control study. Paediatr. Perinat. Epidemiol. 27, 158\u2013164 (2013).","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"27088_CR13","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1080\/14767050802559129","volume":"22","author":"EM McClure","year":"2009","unstructured":"McClure, E. M., Saleem, S., Pasha, O. & Goldenberg, R. L. Stillbirth in developing countries: A review of causes, risk factors and prevention strategies. J. Matern.-fetal Neonatal Med. 22, 183\u2013190 (2009).","journal-title":"J. Matern.-fetal Neonatal Med."},{"key":"27088_CR14","doi-asserted-by":"publisher","first-page":"100123","DOI":"10.1016\/j.xagr.2022.100123","volume":"2","author":"ML Kujabi","year":"2022","unstructured":"Kujabi, M. L. et al. Labor augmentation with oxytocin in low-and lower-middle-income countries: A systematic review and meta-analysis. AJOG Global Reports 2, 100123 (2022).","journal-title":"AJOG Global Reports"},{"key":"27088_CR15","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3126\/kumj.v20i3.53925","volume":"20","author":"S Thakur","year":"2022","unstructured":"Thakur, S. & Dangal, G. Factors associated with intrauterine fetal death at Paropakar maternity women\u2019s hospital. Kathmandu Univ. Med. J. 20, 130 (2022).","journal-title":"Kathmandu Univ. Med. J."},{"key":"27088_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12978-016-0226-9","volume":"13","author":"A Kc","year":"2016","unstructured":"Kc, A. et al. Incidence of intrapartum stillbirth and associated risk factors in tertiary care setting of Nepal: A case-control study. Reprod. Health 13, 1\u201311 (2016).","journal-title":"Reprod. Health"},{"key":"27088_CR17","doi-asserted-by":"publisher","first-page":"e39050","DOI":"10.1371\/journal.pone.0039050","volume":"7","author":"YP Ha","year":"2012","unstructured":"Ha, Y. P., Hurt, L. S., Tawiah-Agyemang, C., Kirkwood, B. R. & Edmond, K. M. Effect of socioeconomic deprivation and health service utilisation on antepartum and intrapartum stillbirth: Population cohort study from rural Ghana. PLoS ONE 7, e39050 (2012).","journal-title":"PLoS ONE"},{"key":"27088_CR18","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.1016\/S0140-6736(10)62187-3","volume":"377","author":"JE Lawn","year":"2011","unstructured":"Lawn, J. E. et al. Stillbirths: Where? When? Why? How to make the data count?. Lancet 377, 1448\u20131463 (2011).","journal-title":"Lancet"},{"key":"27088_CR19","first-page":"1","volume":"13","author":"K Ashish","year":"2016","unstructured":"Ashish, K. et al. Incidence of intrapartum stillbirth and associated risk factors in tertiary care setting of Nepal: A case\u2013control study. Reprod. Health 13, 1\u201311 (2016).","journal-title":"Reprod. Health"},{"key":"27088_CR20","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1","volume-title":"Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis","author":"FE Harrell","year":"2001","unstructured":"Harrell, F. E. Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis Vol. 608 (Springer, 2001)."},{"key":"27088_CR21","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/01621459.1996.10476908","volume":"91","author":"DB Rubin","year":"1996","unstructured":"Rubin, D. B. Multiple imputation after 18+ years. J. Am. Stat. Assoc. 91, 473\u2013489. https:\/\/doi.org\/10.1080\/01621459.1996.10476908 (1996).","journal-title":"J. Am. Stat. Assoc."},{"key":"27088_CR22","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s12978-016-0226-9","volume":"13","author":"KC Ashish","year":"2016","unstructured":"Ashish, K. C. et al. Incidence of intrapartum stillbirth and associated risk factors in tertiary care setting of Nepal: A case-control study. Reprod. Health 13, 103. https:\/\/doi.org\/10.1186\/s12978-016-0226-9 (2016).","journal-title":"Reprod. Health"},{"key":"27088_CR23","doi-asserted-by":"publisher","first-page":"e0182250","DOI":"10.1371\/journal.pone.0182250","volume":"12","author":"FS Chuwa","year":"2017","unstructured":"Chuwa, F. S. et al. Maternal and fetal risk factors for stillbirth in Northern Tanzania: A registry-based retrospective cohort study. PLoS ONE 12, e0182250. https:\/\/doi.org\/10.1371\/journal.pone.0182250 (2017).","journal-title":"PLoS ONE"},{"key":"27088_CR24","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/jech.2009.097170","volume":"65","author":"D Pasupathy","year":"2011","unstructured":"Pasupathy, D., Wood, A. M., Pell, J. P., Fleming, M. & Smith, G. C. S. Advanced maternal age and the risk of perinatal death due to intrapartum anoxia at term. J. Epidemiol. Community Health 65, 241\u2013245 (2011).","journal-title":"J. Epidemiol. Community Health"},{"key":"27088_CR25","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1503\/cmaj.070150","volume":"178","author":"L Huang","year":"2008","unstructured":"Huang, L., Sauve, R., Birkett, N., Fergusson, D. & van Walraven, C. Maternal age and risk of stillbirth: A systematic review. CMAJ Can. Med Assoc. J. J. de l\u2019Assoc. Med. Can. 178, 165\u2013172. https:\/\/doi.org\/10.1503\/cmaj.070150 (2008).","journal-title":"CMAJ Can. Med Assoc. J. J. de l'Assoc. Med. Can."},{"issue":"11","key":"27088_CR26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207061","volume":"13","author":"KH Ahn","year":"2018","unstructured":"Ahn, K. H. et al. Anterior placenta previa in the mid-trimester of pregnancy as a risk factor for neonatal respiratory distress syndrome. PloS one 13(11), e0207061 (2018).","journal-title":"PloS one"},{"key":"27088_CR27","first-page":"12","volume":"4","author":"R Giordano","year":"2010","unstructured":"Giordano, R., Cacciatore, A., Cignini, P., Vigna, R. & Romano, M. Antepartum haemorrhage. J. Prenat. Med. 4, 12\u201316 (2010).","journal-title":"J. Prenat. Med."},{"key":"27088_CR28","doi-asserted-by":"publisher","first-page":"40320","DOI":"10.1038\/srep40320","volume":"7","author":"D Fan","year":"2017","unstructured":"Fan, D. et al. Prevalence of antepartum hemorrhage in women with placenta previa: A systematic review and meta-analysis. Sci. Rep. 7, 40320. https:\/\/doi.org\/10.1038\/srep40320 (2017).","journal-title":"Sci. Rep."},{"key":"27088_CR29","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12884-017-1636-6","volume":"18","author":"K McNamara","year":"2018","unstructured":"McNamara, K., O\u2019Donoghue, K. & Greene, R. A. Intrapartum fetal deaths and unexpected neonatal deaths in the Republic of Ireland: 2011\u20132014; a descriptive study. BMC Pregnancy Childbirth 18, 9. https:\/\/doi.org\/10.1186\/s12884-017-1636-6 (2018).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR30","doi-asserted-by":"publisher","first-page":"020401","DOI":"10.7189\/jogh.08-020401","volume":"8","author":"HL Nathan","year":"2018","unstructured":"Nathan, H. L. et al. Maternal and perinatal adverse outcomes in women with pre-eclampsia cared for at facility-level in South Africa: A prospective cohort study. J. Glob. Health 8, 020401. https:\/\/doi.org\/10.7189\/jogh.08-020401 (2018).","journal-title":"J. Glob. Health"},{"key":"27088_CR31","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1111\/tmi.12606","volume":"20","author":"JL Browne","year":"2015","unstructured":"Browne, J. L. et al. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting. Trop. Med. Int. Health 20, 1778\u20131786. https:\/\/doi.org\/10.1111\/tmi.12606 (2015).","journal-title":"Trop. Med. Int. Health"},{"key":"27088_CR32","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/1471-2393-14-289","volume":"14","author":"ET Dassah","year":"2014","unstructured":"Dassah, E. T., Odoi, A. T. & Opoku, B. K. Stillbirths and very low Apgar scores among vaginal births in a tertiary hospital in Ghana: A retrospective cross-sectional analysis. BMC Pregnancy Childbirth 14, 289 (2014).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR33","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s12872-015-0110-5","volume":"15","author":"M Muti","year":"2015","unstructured":"Muti, M., Tshimanga, M., Notion, G. T., Bangure, D. & Chonzi, P. Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare Zimbabwe. BMC Cardiovasc. Disord. 15, 111 (2015).","journal-title":"BMC Cardiovasc. Disord."},{"key":"27088_CR34","volume-title":"Malaria in Pregnant Women","author":"WHO","year":"2016","unstructured":"WHO. Malaria in Pregnant Women (WHO Geneva, 2016)."},{"key":"27088_CR35","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1186\/s12884-017-1557-4","volume":"17","author":"A Newtonraj","year":"2017","unstructured":"Newtonraj, A., Kaur, M., Gupta, M. & Kumar, R. Level, causes, and risk factors of stillbirth: A population-based case control study from Chandigarh India. BMC Pregnancy Childbirth 17, 371. https:\/\/doi.org\/10.1186\/s12884-017-1557-4 (2017).","journal-title":"BMC Pregnancy Childbirth"},{"key":"27088_CR36","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4103\/ajmhs.ajmhs_82_16","volume":"16","author":"AT Agbata","year":"2017","unstructured":"Agbata, A. T., Eze, J. N., Ukaegbe, C. I., & Odio, B. A 4-year retrospective review of stillbirths at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria. Afr. J. Med. Health Sci. 16, 19\u201324 (2017).","journal-title":"Afr. J. Med. Health Sci."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-27088-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-27088-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-27088-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T17:59:59Z","timestamp":1701712799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-27088-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["27088"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-27088-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-1257663\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-1257663\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]},"assertion":[{"value":"19 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 January 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1013"}}