Changing stillbirth rates: quality of care or quality of patients?

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.