{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:11:04Z","timestamp":1783836664198,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":670,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> We determined the stillbirth rates among singleton births in Gambian hospitals. Contribution of severe obstetric complications was given special attention. <jats:italic>Design.<\/jats:italic> A multi\u2010center retrospective review. <jats:italic>Setting.<\/jats:italic> Three obstetric referral hospitals. <jats:italic>Sample.<\/jats:italic> Fetal outcomes in 826 women with severe maternal morbidity out of 3,280 singleton deliveries. <jats:italic>Methods.<\/jats:italic> All women with severe maternal morbidity reported in the investigated hospitals between January and June 2006 were identified and their cases reviewed. For each case, information about fetal outcome and the mother's age, parity, obstetric complications and delivery mode was abstracted from maternity records. <jats:italic>Main outcome measures<\/jats:italic>. Stillbirth rates and the impact of health service factors. <jats:italic>Results<\/jats:italic>. There were excessively high stillbirth rates with an eight\u2010fold increased risk among women with severe obstetric complications (310\/1,000 births), compared to women without complications (51\/1,000 births). Hemorrhage, anemia, sepsis and hypertensive pregnancy disorders were associated with higher stillbirth rates. Dystocia cases had a relatively lower stillbirth rate. In women with severe obstetric complications, vaginal delivery was associated with a four\u2010fold increased risk of stillbirth compared to cesarean section. <jats:italic>Conclusion<\/jats:italic>. Severe maternal morbidity has significant impact on stillbirth rates. Better access to emergency obstetric care and improved intrapartum care will significantly reduce stillbirth rates in poor settings of the world, such as The Gambia.<\/jats:p>","DOI":"10.1080\/00016340902730318","type":"journal-article","created":{"date-parts":[[2009,1,26]],"date-time":"2009-01-26T22:27:40Z","timestamp":1233008860000},"page":"343-349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Fetal outcome in severe maternal morbidity: Too many stillbirths"],"prefix":"10.1111","volume":"88","author":[{"given":"MAMADY","family":"CHAM","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOHANNE","family":"SUNDBY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SIRI","family":"VANGEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,31]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71048-5"},{"key":"e_1_2_7_3_2","volume-title":"Neonatal and perinatal mortality: country, regional and global estimates","author":"World Health Organization","year":"2006"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68586-3"},{"key":"e_1_2_7_5_2","first-page":"621","article-title":"Perinatal mortality attributable to complications of childbirth in Matlab, Bangladesh","volume":"78","author":"Kusiako T","year":"2000","journal-title":"Bull World Health Organ."},{"key":"e_1_2_7_6_2","volume-title":"Safe motherhood and The World Bank","author":"World Bank","year":"1999"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.01.030"},{"key":"e_1_2_7_8_2","volume-title":"The Gambian road map to accelerate the reduction of maternal & newborn morbidity & mortality","author":"Gambia Government","year":"2005"},{"key":"e_1_2_7_9_2","volume-title":"Evaluation of the availability, utilization and quality of emergency obstetric care services in The Gambia","author":"Njie I","year":"2004"},{"key":"e_1_2_7_10_2","volume-title":"Audit report on maternal deaths in Armed Forces Provisional Ruling Council Hospital 2002","author":"Walraven G.","year":"2003"},{"key":"e_1_2_7_11_2","doi-asserted-by":"crossref","first-page":"510","DOI":"10.4269\/ajtmh.2004.70.510","article-title":"Seasonal variation in the risk and causes of maternal death in the Gambia: malaria appears to be an important factor","volume":"70","author":"Anya SE","year":"2004","journal-title":"Am J Trop Med Hyg."},{"key":"e_1_2_7_12_2","volume-title":"Report on the national survey on maternal, perinatal, neonatal and infant mortality and contraceptive prevalence","author":"Department of State for Health","year":"2002"},{"key":"e_1_2_7_13_2","volume-title":"Making pregnancy safer: the critical role of the skilled attendant. 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