Original Research

Causes of stillbirths at Kgapane hospital, Limpopo province

Gert J.O Marincowitz, Clara Marincowitz
South African Family Practice | Vol 66, No 1 : Part 2| a5863 | DOI: https://doi.org/10.4102/safp.v66i1.5863 | © 2024 Gert J.O. Marincowitz, Clara Marincowitz | This work is licensed under CC Attribution 4.0
Submitted: 03 November 2023 | Published: 17 April 2024

About the author(s)

Gert J.O Marincowitz, Department of Family Medicine, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
Clara Marincowitz, Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and SA Medical Research Council, Cape Town, South Africa


Background: Stillbirths are a global public health challenge, predominantly affecting low- and middle-income countries. The causes of most stillbirths are preventable.

Objectives: this study reviewed perinatal clinical audit data from Kgapane Hospital over a 4-year period with a special focus on the factors associated with stillbirths.

Methods: File audits were done for all stillbirths occurring at Kgapane Hospital and its catchment area from 2018 to 2021. The data from these audits were analysed to identify factors associated with stillbirths.

Results: A total of 392 stillbirths occurred during the study period at Kgapane Hospital and its surrounding clinics, resulting in a stillborn rate of 19.06/1000 births. Of the 392 stillbirths recorded, audits were conducted on 354 of the maternal case records. The five most common causes of stillbirths identified were: hypertensive disorders in pregnancy (HDP) (29.7%), intrauterine growth restriction without HDP (11.6%), birth asphyxia (7.1%), premature labour (< 1000 g) (6.5%) and maternal infections (5.9%) including HIV with unsuppressed VL, intrauterine infection, coronavirus disease (COVID) and syphilis. Modifiable factors that can form the basis of improvement strategies should include training, timeous referral, plus improved resources and staffing.

Conclusion: Understanding the causes of stillbirths can guide improvement strategies to reduce this heart-breaking complication of pregnancy.

Contribution: Family physicians working in rural hospitals are also responsible for perinatal care. Understanding the factors associated with stillbirths will guide them to develop improvement strategies to reduce these preventable deaths.


stillbirths; perinatal; audit; rural heath; district hospital.

Sustainable Development Goal

Goal 3: Good health and well-being


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