Prevalence and risk factors of intrauterine fetal death among pregnant women at banaadir hospital mogadishu, Somalia

Prevalence and risk factors of intrauterine fetal death among pregnant women at banaadir hospital mogadishu, Somalia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and risk factors of intrauterine fetal death among pregnant women at banaadir hospital mogadishu, Somalia Saciid Abdullahi Abshir, Ibrahim Mohamed Mohamud, Abdirahman Abdikariim Ahmed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9441589/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Intrauterine fetal death (IUFD) embraces all fetal deaths weighing 500grams or more occurring both during pregnancy (antepartum death) and during labor (intrapartum). Objectives : the main objective of this study was to identify prevalence and risk factors of intrauterine fetal death among pregnant women at benadir Hospital in Mogadishu, Somalia Methods : The study design is a case control study, the population of this study involved 143 case and 143 controls The sample population consisted of all pregnant women presenting admitted with IUFD in this health facility, and data a checklist was used to obtain information/data from the maternity, operating theatre registers, Data were analyzed by using (SPSS) version 27.. Results : This staudy found that according to age majority of the respondents 25 (31%) were >35 years, according to risk factors are associated with Intrauterine Fetal Demise (IUFD). Prima gravida mothers exhibit a slightly lower risk of IUFD compared to multi gravida mothers. The distribution between these groups is significant, with a p-value of less than 0.005. Mothers with more than 4 children face a significantly higher risk of IUFD compared to those with 1-4 children, with an odds ratio of 0.16 (p < 0.005). A history of previous IUFD significantly increases the risk of recurrence, with an odds ratio of 2 (p < 0.001). Lack of Antenatal Care (ANC) visits elevates the risk of IUFD, as indicated by an odds ratio of 0.91 (p < 0.005). Conversely, malaria during ANC visits is associated with a lower risk of IUFD, with an odds ratio of 0.4 (p < 0.005). These statistical associations highlight the significance of factors like previous IUFD history, ANC visits, and malaria in influencing IUFD risk. Intrauterine growth retardation and congenital anomalies are also significantly linked to IUFD, further emphasizing the importance of early identification and management of these conditions. Conclusion : Various risk factors influence the incidence of Intrauterine Fetal Demise (IUFD), ranging from maternal characteristics to pregnancy history. Factors such as the number of previous pregnancies, maternal health during pregnancy, and obstetric history play crucial roles in determining the likelihood of IUFD occurrence Discussion This study demonstrates a high burden of IUFD in Benadir Hospital, consistent with findings from other low-income settings. Low maternal education and poor access to healthcare services further worsen outcomes. In Somalia, only a small proportion of women complete the recommended antenatal visits, limiting early detection of complications. Figures Figure 1 Introduction Intrauterine fetal death (IUFD) embraces all fetal deaths weighing 500grams or more occurring both during pregnancy (antepartum death) and during labor (intrapartum). Death of a fetus weighing less than 500gms (before 20 weeks) has got a distinct etiology and is usually termed as abortion(1). Intrapartum death is when the cardiac activity had been noted at some stage during -labor and delivery while in antepartum death, no cardiac activity is appreciated from the time of admission to the delivery unit (2). The American College of Obstetricians and Gynecologists defines fetal demise as death of a fetus past 20 weeks of gestation and/or weight of 500grams and above (3). It defines “fetal death” as death prior to the complete expulsion from its mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy(4). The death is indicated by the fact that after such expulsion, the fetus does not breathe of show any evidence of life such as heart beats, pulsation of the umbilical cord or definite movements of voluntary muscles. Heartbeats are to be distinguished from transient cardiac contractions; respirations are be distinguished from fleeting respiratory efforts or gasps.(5)The risk of neonatal death due to complications of intrauterine fetal death birth is at least 12 times higher for an African baby than for a European baby. For example, over 90% of extremely intrauterine fetal death babies (<28 weeks) born in low-income countries die within the first few days of life while only less than 10% of babies of this gestation die in high-income settings(6). However one study in the same West African country, showed that parity (0 or ≥1) and interpregnancy interval (<2 or ≥2 years), PROM and PIH were not associated with intrauterine fetal death delivery. In another study in Nigeria, APH was not associated with intrauterine fetal death birth (7).In Rwanda, Bayingana et al found that previous intrauterine fetal death birth was strongly associated with intrauterine fetal death delivery of LBW (about 4-fold increase in risk) but no correlation between maternal UTI and early delivery was found. 26-28 (8). It is also similar to the 16.8% reported by Nynke R and his colleagues in Malawi13 that involved secondary analysis of data from community based randomized placebo controlled trial for the prevention of intrauterine fetal death birth and WHO population based estimates of intrauterine fetal death birth +that indicate that most countries with a prevalence of more than 15% are in sub-Saharan Africa(9). Nigeria. Though done in a teaching hospital similar to that of the current study, this Nigerian study excluded mothers who were unsure of dates; those who had a discrepancy of more than 2 weeks between gestation by dates and Ballard’s assessment and multiple gestations and may have thus underestimated the prevalence of intrauterine fetal death delivery(10). In Somalia is unknown due to lack of national health data, the latest intra-agency maternal mortality report estimates Somalia to have the second highest maternal mortality ratio (MMR) in the world at 850 maternal deaths per 100,000 live births(11).Early studies reported that about 2% of pregnancies end in perinatal death after 28 weeks gestation, while 10 – 25% of recognized pregnancies end before 28 weeks (12). Today, an estimated 10 – 15% of all recognized pregnancies end in unexpected loss (13).WHO estimates that perinatal mortality rate in Somalia was 81 per 1,000 total births in 2006. 11 A recent study by Blenco we, et al . 4 gave estimates for stillbirth rates as 35.5/1000 births(14).WHO (2015) added that the Horn of Africa is a low income area in a zone that has the maximum number of stillbirths globally today (15). the present study isconducted to assess the extent of stillbirths and to study various maternal, fetal factors influencing occurrence of stillbirths in a teaching hospital in Mogadishu. Methods The study design is a case control study, the population of this study involved 143 case and 143 controls The sample population consisted of all pregnant women presenting admitted with IUFD in this health facility, and data a checklist was used to obtain information/data from the maternity, operating theatre registers, Data were analyzed by using (SPSS) version 27. Results According to age Distribution, The highest percentage of cases (49.0%) falls in the age group of 25-34, indicating that women in this age range are more susceptible to intrauterine fetal death, According to Marital Status, The majority of cases (65.0%) were married, while a significant proportion of widowed women (12.6%) also experienced intrauterine fetal death, According to Educational Level, The majority of cases had an informal education level (23.1%), followed by those with university education (32.2%),According to Occupation, More cases were employed (53.1%) compared to the control group (28.7%).A higher percentage of unemployed individuals were found in the control group (71.3%),According to Residence majority of cases (66.4%) resided in urban areas, while all respondents in the control group were from urban areas. According to Distance from Health Facility, Most cases lived within 0-4 KM from the health facility (44.8%),According to the above table indicates Gravidity, A significant proportion of both cases and controls were multigravida (56.6% and 51.0%, respectively), indicating that women with multiple pregnancies are more prevalent in the study. Primigravida women accounted for 42.7% of cases and 49.0% of controls. According to Parity of the Mother, the above table indicates A noteworthy proportion of cases had a parity of 0 (21.7%), while the majority of controls had a parity of 3 (51.0%).According to the Previous History of IUFD Cases had a higher incidence of previous IUFD (48.3%) compared to controls (6.3%).According to the ANC Visits The vast majority of controls (100.0%) had ANC visits during pregnancy, whereas 28.7% of cases did not have ANC visits. According to presence of Chorio-amnionitis, this study showed that Chorio-amnionitis was present in 40.6% of cases and only 0.7% of controls, indicating a significantly higher incidence among cases. According to Congenital Anomalies, Congenital anomalies were present in 21.0% of cases and 5.6% of controls.According to Type of Pregnancy, Single pregnancies were more prevalent in both cases (88.1%) and controls (74.8%).According to Baby Weight, this study showed that, A significant portion of cases (53.8%) had babies weighing between 2.5-3.5 kg, while 28.0% had babies weighing 3.6-4 kg. CONCLUSION There are many risk factors associated with IUFD, such as Prima gravida mothers have a slightly lower risk of IUFD compared to multi gravida mothers.The odds ratio is not provided for this factor, but the distribution between prima gravida and multi gravida mothers is significant with a p-value of less than 0.005. Discussion This study demonstrates a high burden of IUFD in Benadir Hospital, consistent with findings from other low-income settings. Low maternal education and poor access to healthcare services further worsen outcomes. In Somalia, only a small proportion of women complete the recommended antenatal visits, limiting early detection of complications. Declarations Ethics approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Ethical Review Board Committee of the University of Somalia (UNISO), Faculty of Medicine and Health Sciences (Ref No: UNISO/FMS/SM-0499/615, dated 17 April 2026). Written informed consent was obtained from all participants included in the study. A waiver of informed consent was granted for the retrospective data review where applicable Consent for publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Authors' contributions All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Saciid Abdullahi Abshir, Ibrahim Mohamed Mohamud and Abdirahman Abdikariim Ahmed. The first draft of the manuscript was written by Saciid Abdullahi Abshir and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Acknowledgements Not applicable. References Abaraya M, Seid SS, Ibro SA. Determinants of preterm birth at Jimma University Medical Center, southwest Ethiopia. Pediatr Health Med Ther. 2018;9:101–7. https://doi.org/10.2147/PHMT.S174789 . Archibong EI, Sobande AA, Asindi AA. (2003). Antenatal intrauterine fetal death: a prospective study in a tertiary hospital in south-western Saudi Arabia. Journal of Obstetrics and Gynaecology : The Journal of the Institute of Obstetrics and Gynaecology , 23 (2), 170–173. https://doi.org/10.1080/0144361031000074728 Dhs M, Macro ICF. (2008). Kenya . Fernández-Sola C, Camacho-Ávila M, Hernández-Padilla JM, Fernández-Medina IM, Jiménez-López FR, Hernández-Sánchez E, Conesa-Ferrer MB, Granero-Molina J. Impact of Perinatal Death on the Social and Family Context of the Parents. Int J Environ Res Public Health. 2020;17(10). https://doi.org/10.3390/ijerph17103421 . Ford HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol. 2009;2(2):76–83. Kowalevski J. (1997). State definitions and reporting requirements for live births, fetal deaths, and induced termination of pregnancy. In Hyattsville, Maryland: National Center for Health Statistic . Lucas SB, Mati JK, Aggarwal VP, Sanghvi H. The pathology in perinatal mortality in Nairobi, Kenya. Bull de La Societe de Pathologie Exotique et de Ses Filiales. 1983;76(5):579–83. Mekebo GG, Aga G, Gondol KB, Regesa BH, Woldeyohannes B, Wolde TS, Tadesse G, Galdassa A, Adebe KL, Ketema H. Why Babies die in the first 7 days after birth in Somalia Region of Ethiopia? Annals Med Surg (2012). 2023;85(5):1821–5. https://doi.org/10.1097/MS9.0000000000000690 . Mohamoud AM, Mohamed SM, Hussein AM. (2022). The Epidemiology of Induction of Labor among Women Aged 15–49 Who Delivered at Shaafi Hospital in Hodon District, Mogadishu Somalia 2020 . 418–431. https://doi.org/10.4236/health.2022.144033 Ngare BK, Ronoh Y, Owiny M, Gesare C, Gura Z. (2020). Perinatal Mortality in Emergency Obstetric Health Care Facilities, Nakuru County, Kenya, 2014–2017 : A descriptive cross sectional surveillance data analysis . 3 (4), 2014–2017. Odhiambo A, Rotich EC, Chindia ML, Macigo FG, Ndavi M, Were F. Craniofacial anomalies amongst births at two hospitals in Nairobi, Kenya. Int J Oral Maxillofac Surg. 2012;41(5):596–603. https://doi.org/10.1016/j.ijom.2012.01.009 . Pilliod RA, Cheng YW, Snowden JM, Doss AE, Caughey AB. The risk of intrauterine fetal death in the small-for-gestational-age fetus. Am J Obstet Gynecol. 2012;207(4):e3181–6. https://doi.org/10.1016/j.ajog.2012.06.039 . Thakur SK, Dangal G. Factors Associated with Intrauterine Fetal Death at Paropakar Maternity Women’s Hospital. Kathmandu Univ Med J. 2022;20(79):260–3. Voorhoeve AM, Muller AS, W’oigo H. Machakos Project Studies: agents affecting health of mother and child in a rural area of Kenya. XVI. The outcome of pregnancy. Trop Geogr Med. 1979;31(4):607–27. Tables Tables are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9441589","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":627572605,"identity":"3e0f1149-6034-4028-b20c-b2d3ae9837bf","order_by":0,"name":"Saciid Abdullahi Abshir","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYBACPgYGZhDN2MDffvABkMHDR0gLG1yLxJlkA5AWNuK1MCSYSUBFCGiRSH5szFNjJ9vPcCCt8muOnQwbA/PDRzfwakkzTuY5lmw8s7nx2G3ZbclAh7EZG+fg1ZLDfJi3gTlxw4EDabcltzEDtfCwSROhpT5x/4EEs2LJbfXEaUnmbTicuAHofcaP2w4ToYXnmbHhnGPHjWfcOJMszbjtOA8bMwG/8LMnP5Z4U1Mt29/ffvDjz23V9vzszQ8f49MCAkw8UAYzmMFMQDkIMP5AZ4yCUTAKRsEoQAYAfK1Dcs8FFXwAAAAASUVORK5CYII=","orcid":"","institution":"University of Somalia","correspondingAuthor":true,"prefix":"","firstName":"Saciid","middleName":"Abdullahi","lastName":"Abshir","suffix":""},{"id":627572606,"identity":"b7fbc6f3-cca6-4617-8936-c3f12743f82e","order_by":1,"name":"Ibrahim Mohamed Mohamud","email":"","orcid":"","institution":"University of Somalia","correspondingAuthor":false,"prefix":"","firstName":"Ibrahim","middleName":"Mohamed","lastName":"Mohamud","suffix":""},{"id":627572608,"identity":"7c558f7a-ce31-4000-83cf-c33e8c25b579","order_by":2,"name":"Abdirahman Abdikariim Ahmed","email":"","orcid":"","institution":"Somali International University","correspondingAuthor":false,"prefix":"","firstName":"Abdirahman","middleName":"Abdikariim","lastName":"Ahmed","suffix":""}],"badges":[],"createdAt":"2026-04-16 19:23:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9441589/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9441589/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107839754,"identity":"38897318-bf54-43a2-85ed-6455f0d9e250","added_by":"auto","created_at":"2026-04-26 17:24:24","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":32221,"visible":true,"origin":"","legend":"\u003cp\u003ematernal age of the patient\u003c/p\u003e\n\u003cp\u003eAge Distribution\u003c/p\u003e\n\u003cp\u003eshows age Distribution of risk factors for intrauterine fetal death among the study participants.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9441589/v1/25061069a1b9e9181449f3ed.png"},{"id":107870452,"identity":"e9ed22cb-0ad1-4d4e-b451-f396f5ae7155","added_by":"auto","created_at":"2026-04-27 07:39:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":163995,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9441589/v1/3cfe45e3-448d-4b6b-84df-4a14d67daf93.pdf"},{"id":107839724,"identity":"5514923e-541d-4613-b0f1-94510cd9116c","added_by":"auto","created_at":"2026-04-26 17:24:13","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":16195,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-9441589/v1/4135926cd2020d042e1eb242.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and risk factors of intrauterine fetal death among pregnant women at banaadir hospital mogadishu, Somalia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntrauterine fetal death (IUFD) embraces all fetal deaths weighing 500grams or more occurring both during pregnancy (antepartum death) and during labor (intrapartum). Death of\u0026nbsp;a\u0026nbsp;fetus\u0026nbsp;weighing less than 500gms (before 20 weeks) has got a distinct etiology\u0026nbsp;and is usually\u0026nbsp;termed as abortion(1). Intrapartum death is when the cardiac activity had been noted at some stage during -labor and delivery while in antepartum death, no cardiac activity is appreciated from the time of admission to the delivery unit (2). The\u0026nbsp;American\u0026nbsp;College\u0026nbsp;of\u0026nbsp;Obstetricians\u0026nbsp;and\u0026nbsp;Gynecologists\u0026nbsp;defines\u0026nbsp;fetal\u0026nbsp;demise\u0026nbsp;as death\u0026nbsp;of\u0026nbsp;a\u0026nbsp;fetus past 20 weeks of gestation and/or weight of 500grams and above (3). It defines \u0026ldquo;fetal death\u0026rdquo; as death prior\u0026nbsp;to the complete expulsion from its mother of a product of human conception, irrespective of the\u0026nbsp;duration\u0026nbsp;of\u0026nbsp;pregnancy and\u0026nbsp;which\u0026nbsp;is\u0026nbsp;not\u0026nbsp;an\u0026nbsp;induced\u0026nbsp;termination\u0026nbsp;of\u0026nbsp;pregnancy(4). The death is indicated by\u0026nbsp;the fact that after such expulsion, the fetus does not breathe of show any evidence of life such as heart beats, pulsation of the umbilical cord or definite movements of voluntary muscles. Heartbeats are to be distinguished from transient cardiac\u0026nbsp;contractions;\u0026nbsp;respirations\u0026nbsp;are\u0026nbsp;be distinguished from fleeting respiratory efforts\u0026nbsp;or gasps.(5)The risk of neonatal death due to complications of intrauterine fetal death birth is at least 12 times higher for an African baby\u0026nbsp;than for a European baby. For example, over 90% of extremely intrauterine fetal death babies (\u0026lt;28 weeks) born in low-income countries die within the first few days of life while only\u0026nbsp;less than 10% of babies of this gestation die in high-income settings(6). However one study in the same West African country, showed that parity (0 or \u0026ge;1) and interpregnancy interval (\u0026lt;2 or \u0026ge;2 years), PROM and PIH were not associated with intrauterine fetal death delivery. In another study in Nigeria, APH was not associated\u0026nbsp;with intrauterine fetal death birth (7).In Rwanda, Bayingana et al found\u0026nbsp;that previous intrauterine fetal death birth was strongly\u0026nbsp;associated with intrauterine fetal death delivery of LBW (about 4-fold increase in risk) but no correlation between maternal UTI and early delivery was found. 26-28 (8). It is also similar\u0026nbsp;to the\u0026nbsp;16.8%\u0026nbsp;reported by\u0026nbsp;Nynke\u0026nbsp;R and his colleagues in Malawi13 that involved secondary analysis of data from community based randomized placebo controlled trial for the prevention of intrauterine fetal death birth and WHO population based estimates of intrauterine fetal death birth +that indicate that most countries with a prevalence of more than 15% are in sub-Saharan Africa(9). Nigeria. Though done in a teaching hospital similar to that of the current study, this Nigerian study\u0026nbsp;excluded mothers who were\u0026nbsp;unsure of dates; those who had a discrepancy of more than 2 weeks between gestation by dates and Ballard\u0026rsquo;s assessment and multiple gestations and may have thus underestimated the prevalence of intrauterine fetal death delivery(10). In Somalia\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eis unknown due to lack of national health data, the latest intra-agency maternal mortality report estimates Somalia to have the second highest maternal\u0026nbsp;mortality\u0026nbsp;ratio\u0026nbsp;(MMR)\u0026nbsp;in\u0026nbsp;the\u0026nbsp;world\u0026nbsp;at\u0026nbsp;850\u0026nbsp;maternal\u0026nbsp;deaths\u0026nbsp;per\u0026nbsp;100,000\u0026nbsp;live births(11).Early\u0026nbsp;studies\u0026nbsp;reported\u0026nbsp;that\u0026nbsp;about\u0026nbsp;2%\u0026nbsp;of\u0026nbsp;pregnancies\u0026nbsp;end\u0026nbsp;in\u0026nbsp;perinatal\u0026nbsp;death after 28 weeks\u0026nbsp;gestation,\u0026nbsp;while\u0026nbsp;10\u0026nbsp;\u0026ndash;\u0026nbsp;25%\u0026nbsp;of\u0026nbsp;recognized\u0026nbsp;pregnancies\u0026nbsp;end\u0026nbsp;before\u0026nbsp;28 weeks (12). Today,\u0026nbsp;an\u0026nbsp;estimated 10 \u0026ndash; 15% of all recognized pregnancies end in unexpected loss (13).WHO estimates that\u0026nbsp;perinatal\u0026nbsp;mortality\u0026nbsp;rate\u0026nbsp;in\u0026nbsp;Somalia was\u0026nbsp;81\u0026nbsp;per\u0026nbsp;1,000\u0026nbsp;total\u0026nbsp;births\u0026nbsp;in 2006.\u003csup\u003e11\u003c/sup\u003eA recent study by Blenco we, \u003cem\u003eet al\u003c/em\u003e.\u003csup\u003e4\u003c/sup\u003e gave estimates for stillbirth rates as 35.5/1000 births(14).WHO (2015) added that the Horn of Africa is a low income area in a zone that has the maximum number of stillbirths globally today (15). \u0026nbsp;the present study isconducted to assess the extent of stillbirths and to study various maternal, fetal factors influencing occurrence of stillbirths in a teaching hospital in Mogadishu.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe study design is a case control study, the population of this study involved 143 case and 143 controls The sample population consisted of all pregnant women presenting admitted with IUFD in this health facility, and data a checklist was used to obtain information/data from the maternity, operating theatre registers, Data were analyzed by using (SPSS) version 27.\u003c/p\u003e\n"},{"header":"Results","content":"\u003cp\u003eAccording to age Distribution, The highest percentage of cases (49.0%) falls in the age group of 25-34, indicating that women in this age range are more susceptible to intrauterine fetal death, According to Marital Status, The majority of cases (65.0%) were married, while a significant proportion of widowed women (12.6%) also experienced intrauterine fetal death,\u0026nbsp;According to Educational Level, The majority of cases had an informal education level\u0026nbsp;(23.1%), followed by those with university education (32.2%),According to Occupation, More cases were employed (53.1%) compared to the control\u0026nbsp;group (28.7%).A\u0026nbsp;higher\u0026nbsp;percentage\u0026nbsp;of\u0026nbsp;unemployed\u0026nbsp;individuals\u0026nbsp;were\u0026nbsp;found\u0026nbsp;in\u0026nbsp;the control\u0026nbsp;group (71.3%),According to Residence majority of cases (66.4%) resided in urban areas, while all respondents in the control group were from urban areas.\u003c/p\u003e\n\u003cp\u003eAccording to Distance from Health Facility, Most cases lived within 0-4 KM from the health facility (44.8%),According to the above table indicates Gravidity, A significant proportion of both cases and controls were multigravida (56.6% and 51.0%, respectively), indicating that women with multiple pregnancies are more prevalent in the study. Primigravida women accounted for 42.7% of cases and 49.0% of controls. According to Parity of the Mother, the above table indicates A noteworthy proportion of cases had a parity of 0 (21.7%), while the majority of controls had a parity of 3 (51.0%).According to the Previous History of IUFD Cases had a higher incidence of previous IUFD (48.3%) compared to controls (6.3%).According to the ANC Visits The vast majority of controls (100.0%) had ANC visits during pregnancy, whereas 28.7% of cases did not have ANC visits. According to presence of Chorio-amnionitis, this study showed that Chorio-amnionitis was present in 40.6% of cases and only 0.7% of controls, indicating a significantly higher incidence among cases. According to Congenital Anomalies, Congenital anomalies were present in 21.0% of cases and 5.6% of controls.According to Type of Pregnancy, Single pregnancies were more prevalent in both cases (88.1%) and controls (74.8%).According to Baby Weight, this study showed that, A significant portion of cases (53.8%) had babies weighing between 2.5-3.5 kg, while 28.0% had babies weighing 3.6-4 kg.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThere are many risk factors associated with IUFD, such as Prima gravida mothers have a slightly lower risk of IUFD compared to multi gravida mothers.The odds ratio is not provided for this factor, but the distribution between prima gravida and multi gravida mothers is significant with a p-value of less than 0.005.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study demonstrates a high burden of IUFD in Benadir Hospital, consistent with findings from other\u003c/p\u003e \u003cp\u003elow-income settings. Low maternal education and poor access to healthcare services further worsen outcomes. In Somalia, only a small proportion of women complete the recommended antenatal visits, limiting early detection of complications.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Ethical Review Board Committee of the University of Somalia (UNISO), Faculty of Medicine and Health Sciences (Ref No: UNISO/FMS/SM-0499/615, dated 17 April 2026). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants included in the study. A waiver of informed consent was granted for the retrospective data review where applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAuthors\u0026apos; contributions \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Saciid Abdullahi Abshir, Ibrahim Mohamed Mohamud and Abdirahman Abdikariim Ahmed. The first draft of the manuscript was written by Saciid Abdullahi Abshir and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAcknowledgements \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbaraya M, Seid SS, Ibro SA. Determinants of preterm birth at Jimma University Medical Center, southwest Ethiopia. Pediatr Health Med Ther. 2018;9:101\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2147/PHMT.S174789\u003c/span\u003e\u003cspan address=\"10.2147/PHMT.S174789\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArchibong EI, Sobande AA, Asindi AA. (2003). Antenatal intrauterine fetal death: a prospective study in a tertiary hospital in south-western Saudi Arabia.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cem\u003eJournal of Obstetrics and Gynaecology : The Journal of the Institute of Obstetrics and Gynaecology\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(2), 170\u0026ndash;173. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/0144361031000074728\u003c/span\u003e\u003cspan address=\"10.1080/0144361031000074728\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDhs M, Macro ICF. (2008). \u003cem\u003eKenya\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFern\u0026aacute;ndez-Sola C, Camacho-\u0026Aacute;vila M, Hern\u0026aacute;ndez-Padilla JM, Fern\u0026aacute;ndez-Medina IM, Jim\u0026eacute;nez-L\u0026oacute;pez FR, Hern\u0026aacute;ndez-S\u0026aacute;nchez E, Conesa-Ferrer MB, Granero-Molina J. Impact of Perinatal Death on the Social and Family Context of the Parents. Int J Environ Res Public Health. 2020;17(10). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijerph17103421\u003c/span\u003e\u003cspan address=\"10.3390/ijerph17103421\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFord HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol. 2009;2(2):76\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKowalevski J. (1997). State definitions and reporting requirements for live births, fetal deaths, and induced termination of pregnancy. In \u003cem\u003eHyattsville, Maryland: National Center for Health Statistic\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLucas SB, Mati JK, Aggarwal VP, Sanghvi H. The pathology in perinatal mortality in Nairobi, Kenya. Bull de La Societe de Pathologie Exotique et de Ses Filiales. 1983;76(5):579\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMekebo GG, Aga G, Gondol KB, Regesa BH, Woldeyohannes B, Wolde TS, Tadesse G, Galdassa A, Adebe KL, Ketema H. Why Babies die in the first 7 days after birth in Somalia Region of Ethiopia? Annals Med Surg (2012). 2023;85(5):1821\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/MS9.0000000000000690\u003c/span\u003e\u003cspan address=\"10.1097/MS9.0000000000000690\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohamoud AM, Mohamed SM, Hussein AM. (2022). \u003cem\u003eThe Epidemiology of Induction of Labor among Women Aged 15\u0026ndash;49 Who Delivered at Shaafi Hospital in Hodon District, Mogadishu Somalia 2020\u003c/em\u003e. 418\u0026ndash;431. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4236/health.2022.144033\u003c/span\u003e\u003cspan address=\"10.4236/health.2022.144033\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNgare BK, Ronoh Y, Owiny M, Gesare C, Gura Z. (2020). \u003cem\u003ePerinatal Mortality in Emergency Obstetric Health Care Facilities, Nakuru County, Kenya, 2014\u0026ndash;2017 : A descriptive cross sectional surveillance data analysis\u003c/em\u003e. \u003cem\u003e3\u003c/em\u003e(4), 2014\u0026ndash;2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOdhiambo A, Rotich EC, Chindia ML, Macigo FG, Ndavi M, Were F. Craniofacial anomalies amongst births at two hospitals in Nairobi, Kenya. Int J Oral Maxillofac Surg. 2012;41(5):596\u0026ndash;603. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijom.2012.01.009\u003c/span\u003e\u003cspan address=\"10.1016/j.ijom.2012.01.009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePilliod RA, Cheng YW, Snowden JM, Doss AE, Caughey AB. The risk of intrauterine fetal death in the small-for-gestational-age fetus. Am J Obstet Gynecol. 2012;207(4):e3181\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ajog.2012.06.039\u003c/span\u003e\u003cspan address=\"10.1016/j.ajog.2012.06.039\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThakur SK, Dangal G. Factors Associated with Intrauterine Fetal Death at Paropakar Maternity Women\u0026rsquo;s Hospital. Kathmandu Univ Med J. 2022;20(79):260\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVoorhoeve AM, Muller AS, W\u0026rsquo;oigo H. Machakos Project Studies: agents affecting health of mother and child in a rural area of Kenya. XVI. The outcome of pregnancy. Trop Geogr Med. 1979;31(4):607\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables are available in the Supplementary Files section.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9441589/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9441589/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eIntrauterine fetal death (IUFD) embraces all fetal deaths weighing 500grams or more occurring both during pregnancy (antepartum death) and during labor (intrapartum).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: the main objective of this study was to identify prevalence and risk factors of intrauterine fetal death among pregnant women at benadir Hospital in Mogadishu, Somalia\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: The study design is a case control study, the population of this study involved 143 case and 143 controls The sample population consisted of all pregnant women presenting admitted with IUFD in this health facility, and data a checklist was used to obtain information/data from the maternity, operating theatre registers, Data were analyzed by using (SPSS) version 27..\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: This staudy found that according to age majority of the respondents 25 (31%) were \u0026gt;35 years, according to risk factors are associated with Intrauterine Fetal Demise (IUFD). Prima gravida mothers exhibit a slightly lower risk of IUFD compared to multi gravida mothers. The distribution between these groups is significant, with a p-value of less than 0.005. Mothers with more than 4 children face a significantly higher risk of IUFD compared to those with 1-4 children, with an odds ratio of 0.16 (p \u0026lt; 0.005). A history of previous IUFD significantly increases the risk of recurrence, with an odds ratio of 2 (p \u0026lt; 0.001). Lack of Antenatal Care (ANC) visits elevates the risk of IUFD, as indicated by an odds ratio of 0.91 (p \u0026lt; 0.005). Conversely, malaria during ANC visits is associated with a lower risk of IUFD, with an odds ratio of 0.4 (p \u0026lt; 0.005). These statistical associations highlight the significance of factors like previous IUFD history, ANC visits, and malaria in influencing IUFD risk. Intrauterine growth retardation and congenital anomalies are also significantly linked to IUFD, further emphasizing the importance of early identification and management of these conditions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Various risk factors influence the incidence of Intrauterine Fetal Demise (IUFD), ranging from maternal characteristics to pregnancy history. Factors such as the number of previous pregnancies, maternal health during pregnancy, and obstetric history play crucial roles in determining the likelihood of IUFD occurrence\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study demonstrates a high burden of IUFD in Benadir Hospital, consistent with findings from other\u003c/p\u003e\n\u003cp\u003elow-income settings. Low maternal education and poor access to healthcare services further worsen outcomes. In Somalia, only a small proportion of women complete the recommended antenatal visits, limiting early detection of complications.\u003c/p\u003e","manuscriptTitle":"Prevalence and risk factors of intrauterine fetal death among pregnant women at banaadir hospital mogadishu, Somalia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-26 17:23:49","doi":"10.21203/rs.3.rs-9441589/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d9b8f3a9-76f4-4b21-a805-1d37e391e3c6","owner":[],"postedDate":"April 26th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvited","content":"","date":"2026-05-15T09:35:50+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-26T17:23:52+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-26 17:23:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9441589","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9441589","identity":"rs-9441589","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}