Analysis of the prevalence, etiology, and risk factors of stillbirth from a teaching institute of North Eastern India- a retrospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20220903Keywords:
Intrauterine fetal death, Stillbirth, Stillbirth rate, Antenatal care, Perinatal mortalityAbstract
Background: Stillbirth rate is considered a health index. The worldwide stillbirth rate is 18.4/1000 total birth. This study was aimed to evaluate the prevalence and risk factors of intrauterine fetal death in pregnant women in one of the teaching centers in Northeastern India.
Methods: This was a retrospective study. All cases of intrauterine fetal death admitted in the department of obstetrics gynecology of our institute were included over two and half years. Information was gathered from the medical records of the patients and data were analyzed.
Results: During two and half year’s period, the total number of deliveries was 2696 and the total numbers of stillbirths were 96, hence the stillbirth rate was 35.6/1000. 93 (96.87%) were antenatal stillbirths and 3 (3.12%) were intrapartum stillbirths. 82 (85.41%) women were unbooked. 85 (90.4%) belonged to low socioeconomic status. 67 (69.79%) were preterm. Maximum 39 (40.62%) belonged to 28-35 weeks of gestational age. The most common cause of Intrauterine death (IUD) was antepartum hemorrhage (17.7%). 14 (14.5%) were abruption and 3 were placenta previa. The second most common cause (14.5%) was the hypertensive disorder of pregnancy.
Conclusions: The stillbirth rate in our institute is higher than the national average. The most common causes of IUD were antepartum hemorrhage, preeclampsia, prematurity, and malpresentation which can be diagnosed and managed by increasing uptake of antenatal care which will lead to timely identification and proper management of maternal and fetal complications eventually reducing the preventable stillbirths.
References
Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387:587-603.
Stanton C, Lawn JE, Rahman HZ, Wilczynska-Ketende K, Hill K. Stillbirth rates: delivering estimates in 190 countries. Lancet. 2006;367(9521):1487-943.
McClure EM, Phiri M, Goldenberg RL. Stillbirth in developing countries: a review of the literature. Int J Gynaecol Obstet. 2006;94(2):82-90.
Silver RM, Varner MW, Reddy U, Goldenberg RL, Pinar H, Conway D, et al. Work-up of stillbirth: a review of the evidence. Am J Obstet Gynecol. 2007;196(5):433-44.
Sharma B, Prasad GRV, Aggarwal N, Siwatch S, Suri V, Kakkar N. Aetiology and trends of rates of stillbirth in a tertiary care hospital in the north of India over 10 years: a retrospective study. BJOG. 2019;126(S4):14-20.
Sharma S, Sidhu H, Kaur S. Analytical study of intrauterine fetal death cases and associated maternal conditions. Int J App Basic Med Res. 2016;6:11-3.
Fretts RC, Boyd ME, Usher RH, Ushker HA. The changing pattern of fetal death, 1961 1988. Obstet Gynecol. 1992;79:35 9.
Löfgren O, Polberger S. Perinatal mortality: Changes in the diagnostic panorama 1974 1980. Acta Paediatr Scand. 1983;72:327 32.
Hovatta O, Lipasti A, Rapola J, Karjalainen O. Causes of stillbirth: A clinicopathological study of 243 patients. Br J Obstet Gynaecol. 1983;90:691 6.
Magani IM, Rafla NM, Mortimer G, Meehan FP. Stillbirths: A clinicopathological survey (1972 1982). Pediatr Pathol. 1990;10:363 74.
Misra PK, Thakur S, Kumar A, Tandon S. Perinatal mortality in rural India with special reference to high risk pregnancies. J Trop Pediatr. 1993;39:41 4.
Kumari R, Mengi V, Kumar D. Maternal risk factors and pregnancy wastage in a rural population of Jammu District. JK Sci. 2013;15:82 5.
Bai NS, Mathews E, Nair PM, Sabarinathan K, Harikumar C. Perinatal mortality rate in a south Indian population. J Indian Med Assoc. 1991;89:97 8.
Liu LC, Huang HB, Yu MH, Su HY. Analysis of intrauterine fetal demisedA hospital-based study in Taiwan over a decade. Taiwanese J Obstet Gynecol. 2013;52(4):546-50.
McClure EM, Saleem S, Pasha O. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. J Matern Fetal Neonatal Med. 2009;22:183-90.
Neogi SB, Negandhi P, Chopra S. Risk Factors for stillbirth: findings from a population-based case-control study, Haryana, India. Paediatr Perinat Epidemiol. 2016;30:56-66.
Jehan I, McClure EM, Salat S, Harris H, Moss N, Pasha O, Goldenberg RL. Stillbirths in an urban community in Pakistan. Am J Obstet Gynecol. 2007;197:257.
Korejo R, Bhutta S, Noorani KJ, Bhutta ZA. An audit and trends of perinatal mortality at the Jinnah Postgraduate Medical Centre, Karachi. J Pak Med Assoc. 2007;57(4):168-72.
Asalkar MR, Surve M, Dhakne SR, Shivamurthy HM. Review of causes of stillbirths in a rural referral hospital: a cross sectional study. Int J Reprod Contracept Obstet Gynecol. 2018;7(9):3695-701.
Little RE, Weinberg CR. Risk factors for antepartum and intrapartum stillbirth. Am J Epidemiol. 1993;137:1177 89.
Nayak VN, Gaikwad PR. Causes of still births. J Obstet Gynecol India. 2008;58(4):102-4.
Ananth CV, Savitz DA. Vaginal bleeding and adverse reproductive outcomes: a meta-analysis. Paediatr Perinat Epidemiol. 1994;8:62-78.
Flenady V, Koopmans L, Middleton P. Major risk factors for stillbirth in high-income countries: a systematic review and metaanalysis. Lancet. 2011;377:1331-40.
Dasgupta S, Saha I, Mandal AK. A study on profile of stillbirths. J Indian Med Assoc. 1997;95:175-8.
Efkarpidis S, Alexopoulos E, Kean L, Liu D, Fay T. Case-control study of factors associated with intrauterine fetal deaths. Med Gen Med. 2004;6:53.
Altijani N, Carson C, Choudhury SS, Rani A, Sarma UC, Knight M. Stillbirth among women in nine states in India: rate and risk factors in study of 886,505 women from the annual health survey. BMJ Open. 2018;8:e022583.
Mondal D, Galloway TS, Bailey TC. Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births. BMC Med. 2014;12:220.
Ujwala CH, Guruvare S, Bhat SS, Rai L, Rao S. Evaluation of Placenta in Foetal Demise and Foetal Growth rerstriction. J Clin Diagnost Res. 2013;7(11):2530-3.
