Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023

Abou Sogodogo; Nouhoum Telly; Yah Kone; Salia Keita; Mahamoudou Coulibaly; Oumar Sangho; Cheick Abou Coulibaly; Souleymane Sekou Diarra; Borodjan Diarra; Abdoul Salam Diarra; Hamadoun Sangho

doi:doi:10.11648/j.wjph.20261101.13

Research Article |

| Peer-Reviewed

Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023

Abou Sogodogo^*

, Nouhoum Telly

, Yah Kone, Salia Keita

, Mahamoudou Coulibaly, Oumar Sangho

, Cheick Abou Coulibaly, Souleymane Sekou Diarra, Borodjan Diarra

, Abdoul Salam Diarra

, Hamadoun Sangho

Published in World Journal of Public Health (Volume 11, Issue 1)

Received: 7 December 2025 Accepted: 19 December 2025 Published: 16 January 2026

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Abstract

Background: In-utero fetal death is a public health problem associated with several factors. The main objective was to study the factors associated with in-utero fetal death at the Kalaban-Coro referral health center in 2023. Methods: This was a case-control study including 70 cases and 134 controls. The study was conducted from July 1, 2023, to November 13, 2024. The cases were patients with fetal death who were not in labor, with a gestational age ≥ 22 weeks of amenorrhea or a fetal weight ≥ 500g and with a usable obstetric record. The controls were mothers who had given birth to live babies at term. The data were analyzed using SPSS version 21 software. Logistic regression was performed to identify the factors. The association was considered significant when the confidence interval excluded 1. The significance threshold was 5%. We adhered to the ethical principles of the Declaration of Helsinki. Results: The risk of intrauterine fetal death is five times higher in women with multiple pregnancies (aOR = 5.25; 95% IC: 1.05-26.29). This risk was 16 times higher in women who had experienced antepartum hemorrhage (aOR= 16.4; 95% IC: 1.33-202.7). The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (aOR= 45.4; 95% IC: 2.38-866.4). Conclusion: Advanced prenatal care strategies are needed to reduce the burden of intrauterine fetal death.

Published in	World Journal of Public Health (Volume 11, Issue 1)
DOI	10.11648/j.wjph.20261101.13
Page(s)	20-29
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Intrauterine Fetal Death, Risk Factors, Kalaban-Coro, Mali

1. Introduction

Intrauterine fetal death (IUFD) is defined as any fetal death occurring at 22 weeks of gestation or a birth weight of 500 g or less if gestational age is uncertain

[1]

. It constitutes a public health problem in low- and middle-income countries where healthcare provision is suboptimal. Worldwide, there are approximately 2 million intrauterine fetal deaths each year

[2]

. IUFD accounts for 2% of pregnancies worldwide

[3]

. In Serbia, the incidence of intrauterine fetal death was 0.08% in 2022

[4]

. Three-quarters (¾) of intrauterine fetal deaths occur in sub-Saharan Africa or South Asia

[2]

. In the Democratic Republic of Congo, it accounts for 4% of deliveries at the Jason Sendwe Hospital in Lubumbashi

[5]

. The rate of stillbirth was 3.5% in Tanzania

[6]

, 3.64% at the Sylvanus Olympio Teaching Hospital in Togo

[7]

, and 3.69% in a level II maternity unit in Guinea

[8]

. In Mali, the rate of stillbirth was 1.43% of deliveries at the Commune IV referral health center

[9]

Intrauterine fetal death is associated with several factors, as reported in the literature. Maternal factors include smoking, alcohol consumption, extreme maternal age, primiparity, placental abruption, infection during pregnancy, diabetes, and hypertensive disorders

[3, 10]

. Fetal factors include congenital malformations and growth restriction

[11]

. Despite progress in prenatal care, fetal death remains a problem due to its high frequency and the psychological burden it entails. In most cases, it remains unexplained

[12]

. Identifying risk factors is therefore a cornerstone of the fight against this tragic event. It would allow for better prevention through early detection and appropriate treatment.

The Kalaban-Coro referral health center is a primary peri-urban referral facility that performs more than 2,000 deliveries per year. However, data on risk factors for intrauterine fetal death are rarely used in this facility, hence the importance of this study to enable current professionals to understand the risk factors for intrauterine fetal death and contribute to improving the well-being of the mother-child dyad through the preventive management of intrauterine fetal death. The main objective was to study the factors associated with intrauterine fetal death at the Kalaban-Coro reference health center in 2023.

2. Materials and Methods

2.1. Study Setting

This study was conducted in the gynecology and obstetrics department of the Kalaban-Coro Reference Health Center (CSRef), a primary referral facility in Mali.

2.2. Study Type and Period

This was a case-control study with a ratio of 1 case to 2 controls, conducted from July 1^st, 2023, to November 13^th, 2024, a period of 13 months.

2.3. Study Population

The study included pregnant women who gave birth at the Kalaban-Coro Reference Health Center.

2.3.1. Inclusion Criteria

Cases were patients with fetal death who were not in labor, had a gestational age of 22 weeks or more of amenorrhea, or a fetal weight of 500g or more, and had a usable obstetric record.

Controls were two (2) mothers who delivered live at-term pregnancies immediately after the cases of fetal death. Thus, each case of intrauterine fetal death was compared to two controls. The matching variable was maternal age.

2.3.2. Non-inclusion Criteria

Fetal deaths occurring during delivery and those occurring before the threshold of fetal viability were not included in this study. Similarly, premature and post-term births in the control group were excluded to optimize the analysis.

2.3.3. Sampling Size and Technic

Cases and controls were recruited consecutively. For each case of intrauterine fetal death, two control deliveries were recruited, with age used as a matching variable. The sample size was calculated using statcalc on EpiInfo 7.2 (CDC, Atlanta, USA). The ratio was 1 case to 2 controls. The desired power was 80%, with a control proportion of 44.4%, based on the study conducted by Kangulu IB et al.

[9]

in the Democratic Republic of Congo in 2016. The minimum odds ratio was set at 2.5%, resulting in a sample size of 195 subjects, including 65 cases and 130 controls. In the study implementation, we included 70 cases and 134 controls.

2.4. Variables Studied

The variables of interest were sociodemographic: age (mean ± standard deviation), age group (20 to 34 years, ≤ 19 years, ≥ 35 years), schooling (yes, no), and occupation (housewife, other), marital status (married, single). The clinical and obstetric variables were: number of prenatal visits (none, 1 to 3, ≥ 4), gravidity (primigestive, small pregnancies, multigravestive, very multigravestive), parity (primiparous, small pregnancies, multiparous, very multiparous), gestational age in weeks (22 to 36 weeks, 37 to 41 weeks, ≥ 42 weeks), nature of pregnancy (single, multiple), mode of admission (self-admission, evacuated/referred), general condition (good, fair, poor), presence of fever (yes, no), fetal presentation (cephalic, dystocic), medical history (hypertension, diabetes, miscarriage, intrauterine fetal death, neonatal death, cesarean section). The paraclinical variables were: blood glucose (normal, elevated, not measured), CRP (positive, negative, not measured), thick blood smear (positive, negative, not measured).

2.5. Data Collection and Analysis

Data were collected from obstetric records for all subjects included in the study. Data collection was performed using the Google Forms online tool. Data were analyzed using SPSS version 21. Descriptive statistics were calculated by determining frequencies and counts for categorical variables and the mean ± standard deviation for continuous variables. Binary logistic regression was performed to identify factors associated with intrauterine fetal death, with intrauterine fetal death as the dependent variable. Odds ratios (OR) were calculated with their confidence intervals (CI). An association was considered significant when the confidence interval excluded 1. The significance level was set at 5%.

2.6. Ethical Considerations

We adhered to the ethical principles outlined in the Declaration of Helsinki. All information gathered from the women involved remained confidential. Similarly, the participants' names were kept confidential and were not mentioned in the presentation of the results or associated with them in any way. Respect and confidentiality were upheld.

3. Results

3.1. Frequency of Intrauterine Fetal Death

During the study period, 5,064 deliveries were recorded, including 70 cases of intrauterine fetal death (IUFD), representing a hospital frequency of 1.38%.

3.2. Sociodemographic, Gynecological, and Obstetric Characteristics

In the study, the majority of patients were between 20 and 34 years old (71.4% of cases) and 75.4% of controls. 56% of participants had attended school, compared to 67% of controls. Housewives represented 77% of cases and 65% of controls. Married women represented 85.7% of cases and 94.8% of controls (Table 1). In the control group, 22.9% of participants had attended at least four prenatal consultations, compared to 70.1% of controls. Women with multiple pregnancies and those with few pregnancies were the most represented, at 30% each in the case group, and 24.6% and 23.9% respectively in the control group. The gestational age was between 28 and 36 weeks in 52.9% of the case group compared to 1.5% in the control group. For both the case and control groups, the pregnancy was singleton in 97.1% and 97% respectively (Table 1).

Table 1. Sociodemographic Characteristics of Women Who Gave Birth at the Kalaban-Coro Referral Health Center in 2024 included in the Study.

	Case		Control
	n =70	%	n=134	%
Age category
20 to 34	50	71.4	101	75.4
≤ 19	10	14.3	14	10.5
≥ 35	10	14.3	19	14.2
Schooling
Schooled	39	56.0	90	67.0
Not in school	31	44.0	44	33.0
Occupation
Homemaker	54	77.0	87	65.0
Other	16	23.0	47	35.0
Marital status
Married	60	85.7	127	94.8
Single	10	14.3	7	5.2
Number of prenatal visits
0	11	15.7	1	0.7
1 to 3	43	61.4	39	29.1
≥ 4	16	22.9	94	70.1
Gestation
First pregnancy	11	15.7	35	26.1
Short pregnancy	20	28.6	52	38.8
Multiple pregnancy	21	30.0	33	24.6
Highly multiparous	18	25.7	14	10.4
Parity
Nulliparous	3	4.3	0	0.0
First pregnancy	8	11.4	37	27.6
Short pregnancy	20	28.6	51	38.1
Multiparous	21	30.0	32	23.9
Highly multiparous	18	25.7	14	10.4
Gestational age in weeks
28 to 36 weeks	37	52.9	2	1.5
37 to 41 weeks	32	45.7	132	98.5
≥ 42 weeks	1	1.4	0	0.0
Type of pregnancy
Single	68	97.1	130	97.0
Multiple	2	2.9	4	3.0

Other* Student; Teacher/Secretary; Salesperson/Shopkeeper; Seamstress

3.3. Clinical and Paraclinical Characteristics

Patients were in good general condition in 81.4% of cases and 98.5% of controls. Fetal presentation was cephalic in 88.6% of cases and 96.3% of controls. A history of hypertension was found in 21.4% of cases versus 9% of controls. Diabetes was present in 8.6% of cases and 5.2% of controls. A history of miscarriage was found in 15.7% of cases versus 20.9% of controls. We recorded a history of intrauterine fetal death (IUFD) in 17.1% of cases versus 13.4% of controls. A history of neonatal death and cesarean section represented 8.6% each in cases and 14.9% and 2.2%, respectively, in controls (Table 2). Blood glucose levels were normal in 65.7% of the case group and 82.8% of the control group. C-reactive protein (CRP) and thick blood smear were positive in 10% and 44.3% of the case group, respectively, and in 8.2% and 16.4% of the control group.

Table 2. Clinical Characteristics of Women Who Gave Birth at the Kalaban-Coro Referral Health Center in 2024 Included in the Study.

	Case		Control
	n =70	%	n=134	%
General condition
Good	57	81.4	132	98.5
Fair	12	17.1	2	1.5
Impaired	1	1.4	0	0.0
Fetal presentation
Cephalic	62	88.6	129	96.3
Non-cephalic	8	11.4	5	3.7
History of hypertension
Yes	15	21.4	12	9.0
No	55	78.6	122	91.0
History of diabetes
Yes	6	8.6	7	5.2
No	64	91.4	127	94.8
History of abortion
Yes	11	15.7	28	20.9
No	59	84.3	106	79.1
History of IUFD
Yes	12	17.1	18	13.4
No	58	82.9	116	86.6
History of neonatal death
Yes	6	8.6	20	14.9
No	64	91.4	114	85.1
History of cesarean section
Yes	6	8.6	3	2.2
No	64	91.4	131	97.8

3.4. Risk Factors for Intrauterine Fetal Death

In univariate analysis, the factors associated with intrauterine fetal death were chronic hypertension (crude OR=14.78; 95% CI [1.78-122.70], p=0.013), pre-eclampsia/eclampsia (crude OR=6.19; 95% CI [1.22-31.51], p=0.028), high multigender pregnancies (crude OR=3.97; 95% CI [1.50-10.53], p=0.006), multiparity (crude OR=3.27; 95% CI [1.29-8.29], p=0.012) and high multiparity (crude OR=5.79; 95% CI [2.05-16.32], p=0.001), History of neonatal death (crude OR=3.40; 95% CI [1.62-7.14], p=0.001), antepartum hemorrhage (crude OR=11; 95% CI [2.34-51.75], p=0.002), absence of prenatal care (crude OR=42.78; 95% CI [4.86-376.25], p=0.001), severe iron deficiency anemia (crude OR=5.82; 95% CI [2.14-15.79], p=0.001), and malaria (crude OR=2.87; 95% CI [1.15-7.20], p=0.024) (Table 3).

In the final logistic regression model, the risk of intrauterine fetal death (IUFD) was five times higher in women with multiple pregnancies (aOR = 5.25; 95% CI [1.05–26.29], p = 0.044). This risk was 16 times higher in women who had experienced antepartum hemorrhage (aOR = 16.42; 95% CI [1.33–202.76], p = 0.029). The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (aOR = 45.37; 95% CI [2.38–866.39], p = 0.001) (Table 3).

Table 3. Factors Associated with Intrauterine Fetal Death at the Kalaban Coro Referral Health Center in 2023.

	OR [95% CI]	p	aOR [95%CI]	p
Category of age
20-34	____	__	____	__
≤ 19	1.40 [0.59-3.48]	0.41	1.70 [0.34-8.76]	0.52
≥ 35	1.10 [0.46-2.46]	0.89	0.41 [0.11-1.47]	0.17
Schooling
Schooled	____	__	____	__
Not in school	1.60 [0.89-2.94]	0.11	0.92 [0.38-2.21]	0.85
Occupation
Housewife	____	__	____	-
Other	0.50 [0.28-1.06]	0.08	0.77 [0.30-1.99]	0.59
Chronic Hypertension
No	____	__	____	__
Yes	14.80 [1.78-122.76]	0.01	12.7 [0.48-336.20]	0.13
Diabetes during pregnancy
No	____	__	____	__
Yes	1.93 [0.12-31.29]	0.64	2.05 [0.04-95.40]	0.71
Preeclampsia/Eclampsia
No	____	__	____	__
Yes	6.19 [1.22-31.51]	0.03	1.35 [.038-47.80]	0.87
Gestation
First pregnancy	____	__	____	__
Short pregnancy	1.21 [0.52-2.85]	0.66	2.61 [0.69-9.93]	0.16
Multiple pregnancy	1.91 [0.80-4.56]	0.15	-	-
Highly multiparous	3.97 [1.50-10.53]	<0.01	5.25 [1.05-26.29]	0.04
Parity
First pregnancy	____	__	____	__
Short pregnancy	1.77 [0.70-4.45]	0.22	-	-
Multiple pregnancy	3.27 [1.29-8.29]	0.01	-	-
Highly multiparous	5.79 [2.05-16.32]	<0.01	-	-
History of stillbirth
No	____	__	____	__
Yes	1.33 [0.60-2.95]	0.48	2.44 [0.66-9.02]	0.18
Intrauterine growth restriction
No	____	__	____	__
Yes	0.16 [0.02-1.28]	0.09	0.16 [0.02-1.28]	0.09
History of neonatal death
No	____	__	____	__
Yes	3.40 [1.62-7.14]	<0.01	2.30 [0.86-6.18]	0.10
Ante-patopartum hemorrhage
No	____	__	____	__
Yes	11 [2.34-51.75]	<0.01	16.4 [1.33-202.7]	0.03
Number of prenatal visits
0	42.8 [4.9-376.2]	<0.01	45.4 [2.38-866.4]	0.01
1-3	2.72 [1-7.41]	0.05	3.14 [0.84-11.75]	0.09
≥ 4	____	__	____	__
Fetal presentation
Cephalic	____	__	____	__
No cephalic	1.93 [0.12-31.29]	0.04	0.14 [0.03-0.80]	0.03
Retro-placental hemorrhage
No	____	__	____	__
Oui	8.06 [0.88-73.56]	0.06	1.53 [0.06-39.37]	0.78
Maternal anemia
No	____	__	____	__
Yes	5.82 [2.14-15.79]	<0.01	3.032 [0.66-13.94]	0.15
Malaria
No	____	__	____	__
Yes	2.87 [1.15-7.20]	0.02	1.72 [0.56-5.30]	0.35
Upper urinary tract infection
No	____	__	____	__
Yes	0.48 [0.15-1.51]	0.20	0.218 [0.031-1.536]	0.13
Fetal-maternal incompatibility
No	____	__	____	__
Yes	0.48 [0.20-1.18]	0.11	0.56 [0.17-1.85]	0.34

4. Discussion

4.1. Frequency of Intrauterine Fetal Death

The hospital prevalence of intrauterine fetal death was 1.38% in deliveries at the Kalaban-Coro Referral Health Center. Our prevalence differs from that reported by Kangulu et al., which was 13.98%

[13]

in 2015 and 5.6%

[14]

in the third trimester in 2022 in the Democratic Republic of Congo. In Guinea, Diallo et al.

[15]

reported a prevalence of 6.95% of deliveries at the Mamou Regional Hospital in 2016. In contrast, in France, the prevalence of Intrauterine fetal death is between 0.32% and 0.44% of deliveries

[16]

. The high prevalence of intrauterine fetal death in our context could be explained by the low utilization of healthcare services by the population due to low purchasing power. On the other hand, regarding the behavior of pregnant women in semi-rural areas with respect to prenatal consultations, most women seek prenatal care services late or only when problems exceed their ability to manage them through self-medication.

4.2. Patient Characteristice

The majority of patients were young, married housewives. The same observation was made by Traore FB et al.

[17]

, who reported in their study that their patients were predominantly housewives and married. Diallo MH et al.

[15]

reported a young study population, with 72.7% of cases and 77.3% of controls aged 20 to 34 years, and 81.8% of cases and 95.5% of controls aged 34 to 34 years. These results could be explained by the fact that this period corresponds to the time of sexual activity, but also the period when women are more willing to have children. Nevertheless, we found women under 20 years of age and women over 34 years of age. These age groups constitute risk factors for several complications during pregnancy, according to the literature

[3, 6]

. The participants were educated (56% of cases and 67% of controls). However, Kanagulu et al.

[14]

in 2023 reported that 52.6% of patients in their study in the Democratic Republic of Congo were uneducated. Schooling could promote access to healthcare, especially prenatal consultations, and also the adoption of preventive measures against pregnancy complications.

4.3. Factors Associated with Stillbirth

In univariate logistic regression analysis, chronic hypertension increased the risk of intrauterine fetal death by 14.78 times (p=0.013). Our result is comparable to those in the literature; Dangal et al.

[18]

in Nepal in 2023 found that pregnancy-induced hypertension was a factor in stillbirth. Preeclampsia/eclampsia was associated with a 6.19-fold increased risk of intrauterine fetal death (p=0.028). According to the literature, hypertensive disorders are significant risk factors for intrauterine fetal death. This risk is 2.48 [1.36–4.51] for all types of hypertensive disorders, 2.04 [1.47–2.81] for chronic hypertension, 4.30 [0.31–59.05] for gestational hypertension, and 2.32 [1.52–3.5] for preeclampsia

[16, 19, 20]

. These hypertensive disorders could lead to disruption of placental function with direct consequences on fetal perfusion, resulting in fetal death. Severe iron deficiency anemia (OR crude = 5.82; 95% CI [2.14–15.79]) and malaria (OR crude = 2.87) are also significant risk factors. The 95% CI [1.15-7.20] were risk factors in our univariate analysis. In the study by Chuwa et al.

[6]

, preeclampsia was associated with a 4-fold increased risk of intrauterine fetal death (IUFD) (95% CI [3.38-4.97]), and anemia increased the risk of IUFD by 1.69-fold (95% CI [1.17-2.44]). Since the mother is the primary source of nutrition and development for the fetus, micronutrient deficiency exposes the fetus to the risk of growth restriction and IUFD. In cases of non-cephalic fetal presentation, the risk of IUFD was 1.93 times higher, and there was a significant association between IUFD and non-cephalic fetal presentations. The literature indicates that breech presentation, abnormal fetal position, and dystocia operate through similar mechanisms. the fetus is trapped in the birth canal and is subjected to hypoxia leading to an IUFD

[21]

After adjusting for confounding factors, the following factors remained significantly associated with intrauterine fetal death in the final logistic regression model: high multiparity, antepartum hemorrhage, and lack of prenatal care. The risk of intrauterine fetal death is five times higher in high multiparity women. In the study by Kangulu et al.

[13]

, multiparity increased the risk of intrauterine fetal death by 3.2 times, as did multiparity, which increased it by 2.9 times. These data are consistent with the literature, which indicates that multiparous and multigravida women are also more often of advanced maternal age and are at risk of certain conditions implicated in the causes of intrauterine fetal death, such as placenta previa, placental abruption, hypertension, diabetes mellitus, obesity, and intrauterine growth restriction

[22]

. Indeed, these conditions, associated with multiple pregnancies and multiple parities, amplify the risk of stillbirth. Conditions such as diabetes and hypertension have a complex course, especially during pregnancy. They disrupt the exchange of nutrients and oxygen between mother and fetus, exposing the fetus to a high risk of intrauterine death.

The risk was 16 times higher in women who had experienced antepartum hemorrhage (95% CI [1.33-202.76]). In their study, Dangal et al.

[18]

reported antepartum hemorrhage as a risk factor for stillbirth. Antepartum hemorrhages are relatively common during pregnancy and are caused by placenta previa and placental abruption. These abnormalities threaten the lives of both the mother and the fetus. They disrupt the exchange of nutrients and oxygen between mother and fetus. Its management is multidisciplinary (gynecologists-obstetricians, anesthesiologists-intensivists, midwives, biologists, and interventional radiologists), based on therapeutic protocols, and time is of the essence for the prognosis. Early detection is necessary to limit complications.

The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (95% CI [2.38-866.39]). This result is comparable to that of Vintzileos et al.

[23]

, who showed a tripled risk if the woman had never attended prenatal care. Similarly, Chuwa et al.

[6]

in Tanzania reported that the risk of intrauterine fetal death is doubled when there are fewer than four prenatal care visits (95% CI [1.83-2.45]). Prenatal care allows for the early detection and management of high-risk pregnancies. In the context of limited resources, prenatal care may be perceived as an expense by the population, explaining its non-observance. Awareness campaigns are of paramount importance to explain to the population the benefits of prenatal care, the importance of early management of pathologies during pregnancy, and especially the consequences of not attending prenatal care.

4.4. Strengths and Limitations of the Study

This was the first study to use regression analyses to eliminate confounding factors associated with intrauterine fetal death (IUFD) in our facility. The study was conducted in a primary referral center that receives patients from diverse socio-cultural and economic backgrounds, thus ensuring good sample representativeness. However, data were collected using obstetric records, which could introduce information bias. The selection of controls could be affected by the matching method.

5. Conclusion

The frequency of intrauterine fetal death remains unacceptably high in our healthcare facility and it driven by multiple, largely preventable factors, notably high rates of multi-pregnancies, antepartum hemorrhage, and inadequate utilization of prenatal care services. These findings underscore an urgent need to strengthen prenatal care policies, with particular emphasis on early identification and close monitoring of high-risk pregnancies. Health policy should prioritize the systematic screening and timely management of obstetric hemorrhage through standardized clinical protocol, continuous training of healthcare providers, and improved availability of essential diagnostic and therapeutic resources at the peripheral and referral facilities. Alongside, targeted community-based awareness campaigns should be intensified to improve knowledge of the benefits of early regular prenatal care. Also, policies to improve geographical accessibility through advanced prenatal consultations and financial accessibility through subsidies for additional assessments could reduce the burden of intrauterine fetal death.

Abbreviations

IUFD	Intrauterine Fetal Death
OR	Odds Ratio
aOR	Adjusted Odds Ratio

Author Contributions

Abou Sogodogo: Conceptualization, Data curation, Formal analysis, Methodology, Software, Validation, Visualization, Writing – original draft

Nouhoum Telly: Conceptualization, Formal Analysis, Methodology, Writing – original draft, Writing review & editing

Yah Kone: Conceptualization, Data curation, Formal Analysis, Investigation, Writing – original draft

Salia Keita: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – original draft

Mahamoudou Coulibaly: Data curation, Methodology, Resources, Conceptualization, Methodology, Writing – review & editing

Oumar Sangho: Methodology, Writing – review & editing

Cheick Abou Coulibaly: Methodology, Resources, Supervision, Writing – review & editing

Souleymane Sekou Diarra: Methodology, Resources, Supervision, Validation, Writing – review & editing

Borodjan Diarra: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – review & editing

Abdoul Salam Diarra: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – review & editing

Hamadoun Sangho: Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – review & editing

Funding

This study received no external funding.

Data Availability Statement

All materials and data used in this study are available from the corresponding author upon reasonable request.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Lansac J, Marret H, Oury JF. Accouchement dun enfant malforme´ ou mort in utero. Pratique de laccouchement. Paris : Masson. 2006 : 233-58.
[2]	UNICEF. A Neglected Tragedy: The global burden of stillbirths. UNICEF DATA. 2020 [cite 31 dec 2024]. Disponible sur: https://data.unicef.org/resources/a-neglected-tragedy-stillbirth-estimates-report/
[3]	Quibel T, Bultez T, Nizard J, Subtil D, Huchon C, Rozenberg P. Morts fœtales in utero. Journal de Gynecologie Obstetrique et Biologie de la Reproduction. 1 dec 2014; 43(10): 883-907.
[4]	Jovanovic I, Ivanovic K, Kostic S, Tadic J, Dugalic S, Petronijevic M, et al. Intrauterine Fetal Death in Term Pregnancy-A Single Tertiary Clinic Study. Life (Basel). 10 dec 2023; 13(12): 2320.
[5]	Mpoy CW, Katembo BM, Missumba WK, Kinenkinda XK. Study of utero fetal death in Lubumbashi, Democratic Republic of Congo. Rev l’Infirmier Congo. 2022; 6(1): 21–7.
[6]	Chuwa FS, Mwanamsangu AH, Brown BG, Msuya SE, Senkoro EE, Mnali OP, et al. Maternal and fetal risk factors for stillbirth in Northern Tanzania: A registry-based retrospective cohort study. PLoS One. August 15, 2017; 12(8): e0182250.
[7]	Douaguibe B, Aboubakari AS, Bassowa A, Ajavon D, Ketevi T, Logbo-Akey KE, et al. Fœtal Death in Utero: Maternal Epidemiological and Prognostic Aspects at Sylvanus Olympio Teaching Hospital in Lome. Open Journal of Obstetrics and Gynecology. 29 mars 2019; 9(4): 511-20.
[8]	Momo SAF, Claudine TT, Hawa BO, Marie TP, Telly S. Epidemiological Profile and Management of Pregnant Women Presenting with Intrauterine Fetal Death Before Labor in a Level II Maternity Ward in Guinea. HEALTH SCIENCES AND DISEASE. 5 Feb 2018 [cited 31 Dec 2024]; 19(1) (Suppl). Available from: https://www.hsd-fmsb.org/index.php/hsd/article/view/963
[9]	Niare B. Study of intrauterine fetal death at the reference health center of Commune IV [Thesis]. University of Sciences, Techniques and Technologies of Bamako; 2021 [cited 31 Dec 2024]. Available from: https://www.bibliosante.ml/handle/123456789/4620
[10]	Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 16 avr 2011; 377(9774): 1331-40.
[11]	Avachat SS, Phalke DB, Phalke VD. Risk factors associated with stillbirths in the rural area of Western Maharashtra, India. Archives of Medicine and Health Sciences. juin 2015; 3(1): 56.
[12]	Hankins GDV, Longo M. The role of stillbirth prevention and late preterm (near-term) births. Semin Perinatol. fevr 2006; 30(1): 20-3.
[13]	Kangulu IB, ANkoy AMT, Lumbule JN, Umba EKN, Nzaji MK, Kayamba PKM. Frequency and maternal risk factors for intrauterine fetal death in Kamina, Democratic Republic of Congo. The Pan African Medical Journal. 17 March 2016 [cited 31 Dec 2024]; 23(114). Available from: https://www.panafrican-med-journal.com//content/article/23/114/full
[14]	Kangulu IB, ANkoy AMT, Moyambe JNT, Kalume XK, Kazadi AM, Umba EKN, et al. Prevalence of In Utero Fetal Death in the Third Trimester of Pregnancy in Kamina from January 2021 to May 2022. African Journal of Medicine and Public Health. 25 July 2023; 6(2): 68-88.
[15]	Diallo M, Balde I, Diallo O, Diallo B, Balde A, Barry S. In utero fetal death (IUFD): sociodemographic aspect, management and maternal prognosis at the Maternity Ward of the MaMou Regional Hospital. 2016; 18(3): 2310-234.
[16]	Garabedian C, Sibiude J, Anselem O, Attie-Bittach T, Bertholdt C, Blanc J, et al. Fetal death: formalized consensus of experts from the French National College of Gynecologists and Obstetricians. Gynecology Obstetrics Fertility & Senology. 1 Oct 2024; 52(10): 549-611.
[17]	raore FB, Sidibe Y, Kayentao K, Diarra B, Sima M, Sylla M, et al. Prevalence et facteurs associes a la mortinatalite dans le district de Bamako. 2021; 02(26): 4-15.
[18]	Thakur SK, Dangal G. Factors Associated with Intrauterine Fetal Death at Paropakar Maternity Womens Hospital. Kathmandu Univ Med J (KUMJ). 2022; 20(79): 260-3.
[19]	Fang L, Wang T, Chen L, Zhang S, Chen L, Qin J. Adverse pregnancy outcomes among mothers with hypertensive disorders in pregnancy: A meta-analysis of cohort studies. Pregnancy Hypertens. juin 2021; 24: 107-17.
[20]	Panaitescu AM, Syngelaki A, Prodan N, Akolekar R, Nicolaides KH. Chronic hypertension and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. août 2017; 50(2): 228-35.
[21]	Lawn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ. juin 2005; 83(6): 409-17.
[22]	Kangulu IB, Umba EKN, Nzaji MK, Kayamba PKM. Risk factors for low birth weight in the semi-rural area of Kamina, Democratic Republic of Congo. Pan Afr Med J. 20 March 2014; 17: 220.
[23]	Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. The impact of prenatal care in the United States on preterm births in the presence and absence of antenatal high-risk conditions. Am J Obstet Gynecol. nov 2002; 187(5): 1254-7.

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Sogodogo, A., Telly, N., Kone, Y., Keita, S., Coulibaly, M., et al. (2026). Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World Journal of Public Health, 11(1), 20-29. https://doi.org/10.11648/j.wjph.20261101.13

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ACS Style

Sogodogo, A.; Telly, N.; Kone, Y.; Keita, S.; Coulibaly, M., et al. Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World J. Public Health 2026, 11(1), 20-29. doi: 10.11648/j.wjph.20261101.13

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AMA Style

Sogodogo A, Telly N, Kone Y, Keita S, Coulibaly M, et al. Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World J Public Health. 2026;11(1):20-29. doi: 10.11648/j.wjph.20261101.13

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@article{10.11648/j.wjph.20261101.13,
  author = {Abou Sogodogo and Nouhoum Telly and Yah Kone and Salia Keita and Mahamoudou Coulibaly and Oumar Sangho and Cheick Abou Coulibaly and Souleymane Sekou Diarra and Borodjan Diarra and Abdoul Salam Diarra and Hamadoun Sangho},
  title = {Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023},
  journal = {World Journal of Public Health},
  volume = {11},
  number = {1},
  pages = {20-29},
  doi = {10.11648/j.wjph.20261101.13},
  url = {https://doi.org/10.11648/j.wjph.20261101.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20261101.13},
  abstract = {Background: In-utero fetal death is a public health problem associated with several factors. The main objective was to study the factors associated with in-utero fetal death at the Kalaban-Coro referral health center in 2023. Methods: This was a case-control study including 70 cases and 134 controls. The study was conducted from July 1, 2023, to November 13, 2024. The cases were patients with fetal death who were not in labor, with a gestational age ≥ 22 weeks of amenorrhea or a fetal weight ≥ 500g and with a usable obstetric record. The controls were mothers who had given birth to live babies at term. The data were analyzed using SPSS version 21 software. Logistic regression was performed to identify the factors. The association was considered significant when the confidence interval excluded 1. The significance threshold was 5%. We adhered to the ethical principles of the Declaration of Helsinki. Results: The risk of intrauterine fetal death is five times higher in women with multiple pregnancies (aOR = 5.25; 95% IC: 1.05-26.29). This risk was 16 times higher in women who had experienced antepartum hemorrhage (aOR= 16.4; 95% IC: 1.33-202.7). The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (aOR= 45.4; 95% IC: 2.38-866.4). Conclusion: Advanced prenatal care strategies are needed to reduce the burden of intrauterine fetal death.},
 year = {2026}
}

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TY - JOUR
T1 - Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023
AU - Abou Sogodogo
AU - Nouhoum Telly
AU - Yah Kone
AU - Salia Keita
AU - Mahamoudou Coulibaly
AU - Oumar Sangho
AU - Cheick Abou Coulibaly
AU - Souleymane Sekou Diarra
AU - Borodjan Diarra
AU - Abdoul Salam Diarra
AU - Hamadoun Sangho
Y1 - 2026/01/16
PY - 2026
N1 - https://doi.org/10.11648/j.wjph.20261101.13
DO - 10.11648/j.wjph.20261101.13
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 20
EP - 29
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20261101.13
AB - Background: In-utero fetal death is a public health problem associated with several factors. The main objective was to study the factors associated with in-utero fetal death at the Kalaban-Coro referral health center in 2023. Methods: This was a case-control study including 70 cases and 134 controls. The study was conducted from July 1, 2023, to November 13, 2024. The cases were patients with fetal death who were not in labor, with a gestational age ≥ 22 weeks of amenorrhea or a fetal weight ≥ 500g and with a usable obstetric record. The controls were mothers who had given birth to live babies at term. The data were analyzed using SPSS version 21 software. Logistic regression was performed to identify the factors. The association was considered significant when the confidence interval excluded 1. The significance threshold was 5%. We adhered to the ethical principles of the Declaration of Helsinki. Results: The risk of intrauterine fetal death is five times higher in women with multiple pregnancies (aOR = 5.25; 95% IC: 1.05-26.29). This risk was 16 times higher in women who had experienced antepartum hemorrhage (aOR= 16.4; 95% IC: 1.33-202.7). The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (aOR= 45.4; 95% IC: 2.38-866.4). Conclusion: Advanced prenatal care strategies are needed to reduce the burden of intrauterine fetal death.
VL - 11
IS - 1
ER -

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Author Information

Abou Sogodogo

University Clinical Research Center (UCRC), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

Contact Email

http://orcid.org/0009-0008-2088-193X
Nouhoum Telly

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali;Sectoral Unit for the Fight Against HIV/AIDS Tuberculosis and Viral Hepatitis (CSLS-TBH), Ministry of Health and Social Development, Bamako, Mali

http://orcid.org/0000-0003-0976-152X
Yah Kone

Gynecology and Obstetrics Department, Kalaban-Coro Reference Health Center, Bamako, Mali
Salia Keita

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

http://orcid.org/0009-0008-0647-9709
Mahamoudou Coulibaly

Gynecology and Obstetrics Department, Kalaban-Coro Reference Health Center, Bamako, Mali
Oumar Sangho

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

http://orcid.org/0000-0003-2856-0395
Cheick Abou Coulibaly

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali
Souleymane Sekou Diarra

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali
Borodjan Diarra

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

http://orcid.org/0009-0004-4134-8609
Abdoul Salam Diarra

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

http://orcid.org/0000-0003-3363-7860
Hamadoun Sangho

Department of Teaching and Research in Public Health and Specialties (DERSP), University of Science Technologies and Technologies of Bamako (USTTB), Bamako, Mali

http://orcid.org/0000-0001-8636-8508

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APA Style

Sogodogo, A., Telly, N., Kone, Y., Keita, S., Coulibaly, M., et al. (2026). Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World Journal of Public Health, 11(1), 20-29. https://doi.org/10.11648/j.wjph.20261101.13

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ACS Style

Sogodogo, A.; Telly, N.; Kone, Y.; Keita, S.; Coulibaly, M., et al. Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World J. Public Health 2026, 11(1), 20-29. doi: 10.11648/j.wjph.20261101.13

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AMA Style

Sogodogo A, Telly N, Kone Y, Keita S, Coulibaly M, et al. Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023. World J Public Health. 2026;11(1):20-29. doi: 10.11648/j.wjph.20261101.13

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@article{10.11648/j.wjph.20261101.13,
  author = {Abou Sogodogo and Nouhoum Telly and Yah Kone and Salia Keita and Mahamoudou Coulibaly and Oumar Sangho and Cheick Abou Coulibaly and Souleymane Sekou Diarra and Borodjan Diarra and Abdoul Salam Diarra and Hamadoun Sangho},
  title = {Risk Factors Associated with Intrauterine Fetal Death at the Kalaban-Coro Reference Health Center in Mali, 2023},
  journal = {World Journal of Public Health},
  volume = {11},
  number = {1},
  pages = {20-29},
  doi = {10.11648/j.wjph.20261101.13},
  url = {https://doi.org/10.11648/j.wjph.20261101.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20261101.13},
  abstract = {Background: In-utero fetal death is a public health problem associated with several factors. The main objective was to study the factors associated with in-utero fetal death at the Kalaban-Coro referral health center in 2023. Methods: This was a case-control study including 70 cases and 134 controls. The study was conducted from July 1, 2023, to November 13, 2024. The cases were patients with fetal death who were not in labor, with a gestational age ≥ 22 weeks of amenorrhea or a fetal weight ≥ 500g and with a usable obstetric record. The controls were mothers who had given birth to live babies at term. The data were analyzed using SPSS version 21 software. Logistic regression was performed to identify the factors. The association was considered significant when the confidence interval excluded 1. The significance threshold was 5%. We adhered to the ethical principles of the Declaration of Helsinki. Results: The risk of intrauterine fetal death is five times higher in women with multiple pregnancies (aOR = 5.25; 95% IC: 1.05-26.29). This risk was 16 times higher in women who had experienced antepartum hemorrhage (aOR= 16.4; 95% IC: 1.33-202.7). The absence of prenatal care increased the risk of intrauterine fetal death by 45.37 times (aOR= 45.4; 95% IC: 2.38-866.4). Conclusion: Advanced prenatal care strategies are needed to reduce the burden of intrauterine fetal death.},
 year = {2026}
}

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