Introduction: Stillbirth is a significant global public health issue,
with approximately 98% occurring in low- and middle-income countries.
The Solomon Islands is a Pacific nation with poor perinatal outcomes and
very little previous research investigating stillbirth. Methods: We
conducted a retrospective cohort study investigating all stillbirths at
the National Referral Hospital in Honiara, Solomon Islands, between
January 2017 and December 2018. Causes of stillbirth and risk factors
were classified on review of available case files. Results: Over two
years, there were 341 stillbirths and 11,056 total births at the
National Referral Hospital (30.8 stillbirths per 1000 births). Cause of
death was documented for 198 and 142 full case files were available.
Most stillbirths occurred antenatally (n=170/198) and 62% were at
preterm gestations (<37 weeks). Low birthweight
(<2500g) was present in 59% (n=84/142) and preventable
maternal conditions, including hypertensive disorders and syphilis, were
present in 42% (n=59/142) of cases. Acute events caused 46% of
intrapartum deaths and 92% of these had inadequate intrapartum
monitoring. Conclusion: Our study is the first to investigate causes of
stillbirth in the Solomon Islands. We found a large proportion of
preventable stillbirths and significant gaps in documentation. This
highlights the importance and feasibility of a national registry. There
is an urgent need for targeted training in data collection, improved
quality of antenatal and intrapartum care and community awareness to
reduce preventable stillbirths in the Asia-Pacific.