Stillbirths in Jordan: rate, causes, and preventability

Objectives: This study aimed to determine the stillbirth rate in Jordan and to determine the leading causes of stillbirths. Analyzing the stillbirth data from a large sample size of Jordanian women would be very valuable for planning the resources and improving the services. Methods: The data from the national study of perinatal mortality in Jordan were analyzed. A total of 21,980 women who delivered at a gestational age >= 20 weeks in any of the 18 selected hospitals during the study period (March 2011-April 2012) were analyzed. The stillbirth rate was calculated as the number of stillbirths per 1000 total births. The deaths were also classified according to NICE classification system. Results: The rates of stillbirths were 11.6/1000 total births born after 20 weeks of gestation, 11.2/1000 total births born >= 22 weeks of gestation, 10.6/1000 total births born >= 24 weeks of gestation, and 9.0/1000 total births born >= 28 weeks of gestation. According to NICE classification, the main causes of stillbirths were maternal diseases (19.5%), unexplained immaturity (18.8%), congenital anomalies (17.6%), unexplained antepartum stillbirths (17.6%), obstetric complications (8.4%), placental abruption (5.7%), and multiple births (5%). The expert Panel judged that 34.5% of all fetal deaths were preventable and 30.3% were possibly preventable with optimal care. Conclusions: This study highlighted stillbirth risks in Jordan, which could encourage maternal-infant health-care providers, other researchers, policymakers, and stakeholders to implement solutions and to develop a feasible intervention.