ArticleBMJ global health2021
Influence of travel time and distance to the hospital of care on stillbirths: a retrospective facility-based cross-sectional study in Lagos, Nigeria.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 34 citations in OpenAlex.
- Multistakeholder perspectives on geographical accessibility to emergency obstetric care in Benin City, Nigeria.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Inter-facility travel time and referral for emergency obstetric care in the 15 most populated cities of Nigeria: a spatial analysis.BMC global and public health · 2026Article
- Association between out-of-pocket health expenditures and low birth weight in Eastern Ethiopia: a generalized structural equation modeling (GSEM).BMC public health · 2025Article
- Prevalence and factors associated with stillbirth in mothers delivered by cesarean section at Orotta National Referral Maternity Hospital: case-control study.BMC pregnancy and childbirth · 2025Article
- Disparities in stillbirth rates according to municipal deprivation levels: a nationwide study in Brazil.BMC pregnancy and childbirth · 2025Observational
- Associations between nighttime or weekend deliveries and adverse maternal, birth, and neonatal outcomes: secondary analysis of the MANGO study in western Kenya.BMC pregnancy and childbirth · 2025Article
- Beyond proximity: an observational study of stillbirth rates and emergency obstetric and newborn care accessibility in The Gambia.BMJ global health · 2025Observational
- Pooled prevalence and multilevel determinants of stillbirths in sub-Saharan African countries: implications for achieving sustainable development goal.Global health research and policy · 2025Article
- Inequalities in geographical access to emergency obstetric and newborn care.Bulletin of the World Health Organization · 2024Article
- Assessing the Link between Maternal Transport Modes and Childhood Mortality in Nigeria.Maternal and child health journal · 2024Article
- Choosing a maternity hospital: a matter of travel distance or quality of care?Research in health services & regions · 2024Article
- Socio-spatial equity analysis of relative wealth index and emergency obstetric care accessibility in urban Nigeria.Communications medicine · 2024Article
- Rates and risk factors for antepartum and intrapartum stillbirths in 20 secondary hospitals in Imo state, Nigeria: A hospital-based case control study.PLOS global public health · 2024Article
- Effects of community-based interventions for stillbirths in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Factors associated with antepartum pilgrimage at a reference maternity hospital in Ceará.Revista da Escola de Enfermagem da U S P · 2024Article
- Optimising availability and geographical accessibility to emergency obstetric care within a sub-national social health insurance scheme in Nigeria.Frontiers in health services · 2024Article
- A geospatial database of close-to-reality travel times to obstetric emergency care in 15 Nigerian conurbations.Scientific data · 2023Article
- Timing of perinatal death; causes, circumstances, and regional variations among reviewed deaths in Ethiopia.PloS one · 2023Article
- Travel of pregnant women in emergency situations to hospital and maternal mortality in Lagos, Nigeria: a retrospective cohort study.BMJ global health · 2022Article
- Use of motorised transport and pathways to childbirth care in health facilities: Evidence from the 2018 Nigeria Demographic and Health Survey.PLOS global public health · 2022Article
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Authors and funding
4 authors at 4 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAccess to emergency obstetric care can lead to a 45%-75% reduction in stillbirths. However, before a pregnant woman can access this care, she needs to travel to a health facility. Our objective in this study was to assess the influence of distance and travel time to the actual hospital of care on stillbirth.
methodsWe conducted a retrospective cross-sectional study of pregnant women who presented with obstetric emergencies over a year across all 24 public hospitals in Lagos, Nigeria. Reviewing clinical records, we extracted sociodemographic, travel and obstetric data. Extracted travel data were exported to Google Maps, where typical distance and travel time for period-of-day they travelled were extracted. Multivariable logistic regression was conducted to determine the relative influence of distance and travel time on stillbirth.
resultsOf 3278 births, there were 408 stillbirths (12.5%). Women with livebirths travelled a median distance of 7.3 km (IQR 3.3-18.0) and over a median time of 24 min (IQR 12-51). Those with stillbirths travelled a median distance of 8.5 km (IQR 4.4-19.7) and over a median time of 30 min (IQR 16-60). Following adjustments, though no significant association with distance was found, odds of stillbirth were significantly higher for travel of 10-29 min (OR 2.25, 95% CI 1.40 to 3.63), 30-59 min (OR 2.30, 95% CI 1.22 to 4.34) and 60-119 min (OR 2.35, 95% CI 1.05 to 5.25). The adjusted OR of stillbirth was significantly lower following booking (OR 0.37, 95% CI 0.28 to 0.49), obstetric complications with mother (obstructed labour (OR 0.11, 95% CI 0.07 to 0.17) and haemorrhage (OR 0.30, 95%CI 0.20 to 0.46)). Odds were significantly higher with multiple gestations (OR 2.40, 95% CI 1.57 to 3.69) and referral (OR 1.55, 95% CI 1.13 to 2.12).
conclusionTravel time to a hospital was strongly associated with stillbirth. In addition to birth preparedness, efforts to get quality care quicker to women or women quicker to quality care will be critical for efforts to reduce stillbirths in a principally urban low-income and middle-income setting.
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