Main Article Content
The prevalence rate of stillbirth is ten times higher in developing countries relative to developed countries with a 2016 rate of 18 percent in Ghana. This study employed the Quadratic Discriminant Function for discriminating and classifying of pregnancy outcomes based on some predictors. The study further examined the sensitivity of the Quadratic Discriminant Function in predicting pregnancy outcomes with variations in the training and test samples of deliveries recorded in a hospital in Accra, Ghana. The study considered the scenarios; 50:50, 60:40, 70:30 and 75:25 ratios of training sets to testing sets. Predictor variables on both maternal factors (maternal age, parity and gravida) and fetus variables (weight at birth and gestational period) were all statistically significant (P < .01) in discriminating between live birth and stillbirth. Results showed that maternal age had a negative effect on the live birth outcomes, while parity, gravida, gestational period and fetus weight recorded positive effects on live birth outcomes. The 75:25 ratio outperformed the other ratios in discriminating between live and stillbirth based on the Actual Error Rate of 7.28% compared to 7.81%, 12.14% and 13.79% for the 50:50, 70:30 and 60:40 ratios respectively whereas, the receiver operating characteristic curve shows the 70:30 (AUC= 0.9233) ratio outperformed the others. The study recommend the use of either the 70:30 or 75:25 training to test ratios for classification and discrimination related problems. Moreover, further research to establish the power of the respective training to test sample ratios with other statistical classification tools and more socio-economic variables can be considered.
World Health Organization. The partnership for maternal, newborn and child health. Opportunities for Africa’s Newborn; 2006.
Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, Shiekh S. Stillbirths: Rates, risk factors, acceleration towards 2030. The Lancet. 2016;387(10018):587-603.
World Health Organization. Make every mother and child count. The World Health Report 2005; 2005.
World Health Organization. Department of maternal, newborn, child and adolescent health (MCA): Progress report 2014–15. World Health Organization; 2016.
McClure EM, Pasha O, Goudar SS, Chomba E, Garces A, Tshefu A, Althabe F, Esamai F, Patel A, Wright LL, Moore J. Epidemiology of stillbirth in low‐middle income countries: A global network study. Acta Obstetricia et Gynecologica Scandinavica. 2011;90(12):1379-1385.
Stanton C, Lawn JE, Rahman H, Wilczynska-Ketende K, Hill K. Stillbirth rates: Delivering estimates in 190 countries. Lancet. 2006;367(9521):1487-94.
Bendon R. Review of some causes of stillbirth. Pediatr Dev Pathol. 2001;517-3.
Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, Lancet's. Stillbirths Series Steering Committee. Stillbirths: Where? When? Why? How to make the data count? The Lancet. 2011;377(9775):1448-1463.
Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. Maternal and fetal risk factors for stillbirth: Population based study. BMJ. 2013;346:108.
Habib NA, Lie RT, Oneko O, Shao J, Bergsjø P, Daltveit AK. Socio-demographic characteristics and perinatal mortality among singletons in North East Tanzania: A registry-based study. Journal of Epidemiology & Community Health. 2008;62(11):960-965.
MacDorman MF, Gregory EC. Fetal and perinatal mortality: United States, 2013. National vital statistics reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2015;64(8):1-24.
Eftekhar M, Pourmasumi S, Sabeti P, Mirhosseini F. Relation of second hand smoker and effect on pregnancy outcome and newborns parameters. Women’s Health Gynecology. 2016;6(2).
Ghana. Statistical Service. 2010 Population and Housing Census Report. Ghana Statistical Service; 2014.
Johnson RA, Wichern DW. Applied multivariate statistical analysis, 6th Edition. Prentice-Hall, London; 2007.
Poulsen J, French A. Discriminant function analysis. San Francisco State University: San Francisco, CA; 2008.
Box GE. A general distribution theory for a class of likelihood criteria. Biometrika. 1949;36(3/4):317-346.
Huberty CJ. Issues in the use and interpretation of discriminant analysis. Psychological Bulletin. 1984;95(1):156.
Cook NR. Statistical evaluation of prognostic versus diagnostic models: Beyond ROC curve. Clim Chem. 2008;54(1):17-23.
Audu BM, Alhaji MA, Takai UI, Bukar M. Risk factors for stillbirths at University of Maiduguri Teaching Hospital, Maiduguri, Nigeria: A cross-sectional retrospective analysis. Niger Med J. 2010;50(2):42- 46.
Feresu SA, Harlow SD, Welch K, Gillespie BW. Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: A cross-sectional retrospective analysis. BMC Pregnancy and Childbirth. 2005;5(1):9.
Tilahun D, Assefa T. Incidence and determinants of stillbirth among women who gave birth in Jimma University Specialized Hospital, Ethiopia. Pan African Medical Journal. 2017;28(1).
Jammeh A, Vangen S, Sundby J. Stillbirths in rural hospitals in the Gambia: A cross-sectional retrospective study. Obstetrics and Gynecology International. 2010;1-8.
Gordon A, Raynes-Greenow C, McGeechan K, Morris J, Jeffery H. Risk factors for antepartum stillbirth and the influence of maternal age in New South Wales Australia: A population based study. BMC Pregnancy and Childbirth. 2017;13(1):12.