Review of causes of stillbirths in a rural referral hospital: a cross sectional study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20183779Keywords:
Abruption, Anaemia, Perinatal mortality, Preeclmpsia, StillbirthsAbstract
Background: The birth of a newborn after twenty-eight completed weeks of gestation weighing 1,000 gm or more, with baby showing no signs of life after delivery is a still born’’. Such death includes both antepartum and intrapartum death. Stillbirths (SB) are the largest contributor to perinatal mortality. Of the estimated 3 million stillbirths which occur yearly, the vast majority are in developing countries, with rates in many developing countries ten-fold higher than elsewhere.
Methods: Descriptive (cross sectional) study was conducted at tertiary referral hospital in rural area of Maharashtra from September 2015 to August 2017. Out of total 3235 deliveries during study period 64 mothers giving birth to 66 cases of still birth (2 cases of twins) satisfied the inclusion criteria and studied to find out prevalence, causes and high-risk factor association with stillbirth.
Results: Stillbirth rate in our study was 20.4/1000 deliveries. 56.25% patients were in the 21-25 years age group.9.3% were illiterate while 57.81% had education below 12th standard. Most patients were from low socioeconomic status and 57.81% were unregistered. Stillbirth was more common in Para (2-4), premature baby and with male sex preponderance in our study. Most patients 90.62% were delivered vaginally. Preeclmpsia, Abruption, Anaemia were common high-risk factor associated with stillbirth.54.6% cases were unexplained stillbirth while IUGR was noted in 23.4% cases and other causes noted were prematurity, congenital anomaly, cord and placental causes were found in our study.
Conclusions: A significant proportion of stillbirths are preventable by adequate antenatal care. Female literacy and health education, adequate antenatal care, identification of high-risk cases, and timely referral needs to be emphasized among the medical and paramedical personnel at the first point of contact with the pregnant women.
Metrics
References
International statistical classification of disease and related health problems,10th Revision, vol.2, Instruction manual. Geneva: World Health Organization; 1993.
Stanton C, Lawn JE, Rahman H, Wilczynska-Ketende K, Hill K. Stillbirth rates: delivering estimates in 190 countries. Lancet. 2006;367(9521):1487-94.
Smith GC, Fretts RC. Stillbirth. Lancet. 2007;370(9600):1715-25.
McClure EM, Saleem S, Pasha O, Goldenberg RL. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. J Maternal-fetal Neonatal Med. 2009;22(3):183-90.
McClure EM, Nalubamba‐Phiri M, Goldenberg RL. Stillbirth in developing countries. Int J Gynecol Obstetr. 2006;94(2):82-90.
Briefing Paper, Registration of Stillbirth: Catherine Fairbairn, House of Commons Library.2018;05595:6.
Section 56(1) of the Registration of Births, Deaths and Marriages (Scotland)Act1965, as amended by the Stillbirth (Definition)Act 1992.
Births and Deaths Registration (Northern Ireland) Order 1976, as amended by the Stillbirth Definition Northern Ireland Order 1992 0
Stillbirths. Centers for Disease Control and Prevention (CDC). Available at http://www.cdc.gov/ncbddd/bd/stillbirths.htm. Retrieved 01/11/2017
Vergani P, Cozzolino S, Pozzi E, Cuttin MS, Greco M, Ornaghi S, et al. Identifying the causes of stillbirth: a comparison of four classification systems. Am J Obstetr Gynecol. 2008;199(3):319-e1
Dhar A. India has highest number of stillbirth. Lancet report. The Hindu. Available at www.thehindu.com/sci-tech/health/policy-and-issues/india-has-highest-number-of-stillbirths-lancet-report/article1694409.ece. Accessed on 30th May 2018.
Blencowe H, Cousens S, Jassir FB, Say L, Chou D, Mathers C, Hogan D, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Global Health. 2016;4(2):e98-108
Available at http://www.censusindia.gov.in/vital_statistics/SRS_Report_2012/11_Chap_4_2012.pdf accessed on 1st June 2018
Sharma S, Sidhu H, Kaur S. Analytical study of intrauterine fetal death cases and associated maternal conditions. Int J Applied Basic Med Res. 2016;6(1):11.
Fretts RC, Boyd ME, Usher RH, Usher HA. The changing pattern of fetal death, 1961-1988. Obstetr Gynecol. 1992;79(1):35-9.
Misra PK, Thakur S, Kumar A, Tandon S. Perinatal mortality in rural India with special reference to high risk pregnancies. J Tropical Pediatr. 1993;39(1):41-4.
Dasgupta S, Saha I, Mandal AK. A study on profile of stillbirths. J Indian Med Association. 1997 Jun;95(6):175-8.
Lakshmi ST, Thankam U, Jagadhamma P, Ushakumari A, Chellamma N, Hariharan SV. Risk factors for still birth: a hospital based case control study. Int J Reprod Contracept Obstet Gynecol. 2017;6:970-4
Saxena V, Bansal S, Chaturvedi J, Kalra BP, Chandra V, Kansal S. Investigating causes and factors associated with stillbirth by verbal autopsy in Uttarakhand. Indian J Prev Soc Med. 2011;42:14-8
Ashish KC, Nelin V, Wrammert J, Ewald U, Vitrakoti R, Baral GN et al. Risk factors for antepartum stillbirth: a case-control study in Nepal. BMC pregnancy and childbirth. 2015;15(1):146.
Roy MP. Mitigating the stillbirth challenge in India. Lancet. 2016;387(10032):1995.
Ghimire PR, Agho KE, Renzaho A, Christou A, Nisha MK, Dibley M, et al. Socio-economic predictors of stillbirths in Nepal (2001-2011). PloS one. 2017;12(7):e0181332.
Kumari C, Kadam NN, Kshirsagar A, Shinde A. Intrauterine fetal death: A prospective study. J Obstet Gynecol India. 2001;51(5):94-7.
NFHS Survey IIPS and DRC macro2001(b). Available at: http://rchiips.org/nfhs/nfhs3.shtml. National family Health survey-3 (2005-2006)
Hashim N, Naqvi S, Khanam M, Jafry HF. Primiparity as an intrapartum obstetric risk factor. J Pakistan Med Associat. 2012;62(7):694.
Kameswaran C, Bhatia BD, Bhat BV, Oumachigui A. Perinatal mortality: a hospital based study. Indian Pediatr. 1993;30(8):997-1001.
Ravikumar M, Devi A, Bhat V et al. Analysis of stillbirth in a rural referral hospital. J Obstet Gynaecol India. 1996;45:791-6.
Little RE, Weinberg CA. Risk factors for antepartum and intrapartum stillbirth. Am J Epidemiol. 1993;137(11):1177-89.
Raymond EG, Cnattingius S, Kiely JL. Effects of maternal age, parity, and smoking on the risk of stillbirth. BJOG: Int J Obstet Gynaecol. 1994;101(4):301-6.
Dasgupta S, Saha I, Mandal AK. A study on profile of stillbirths. J Indian Med Assoc. 1997;95(6):175-8.
Engel PJ, Smith R, Brinsmead MW, Clifton VL. Male sex and pre‐existing diabetes are independent risk factors for stillbirth. Aus NZ J Obstet Gynaecol. 2008;48(4):375-83.
Fuster V, Zuluaga P, Roman-Busto J. Stillbirth incidence in Spain: a comparision of native and recent immigrant others. Demographic Res. 2014;31(29):889-912.
Green MS. The male predominance in the incidence of infectious diseases in children: a postulated explanation for disparities in the literature. Int J Epidemiol. 1992;21(2):381-6.
Ulizzi L, Zonta LA. Sex differential patterns in perinatal deaths in Italy. Hum Biol. 2002:879-88.
Harrison MS, Robert L. Goldenberg. Global burden of prematurity. Seminars in fetal and neonatal medicine. 2016;21(2):74-9.
Nayak AH, Dalal AR. A review of stillbirths. J Obstet Gynaecol India. 1993;43:225-9.
Uchil NA, Nanavati MS, Purandare CB et al. Antenatal stillbirths. J Obstet Gynaecol India. 1990;40:361-3.
Shrestha SR, Yadav BK, Risk factors associated with still births. J Nepal Med Assoc. 2010;49(177):84-7.
Nouaili EB, Chaouachi S, Ayadi I, Said AB, Zouari B, Marrakchi Z. Risk factors for perinatal mortality in a Tunisian population. Int J Gynecol Obstet. 2010;111(3):265-6.
Stringer EM, Vwalika B, Killam WP, Giganti MJ, Mbewe R, Chi BH, et al. Determinants of stillbirth in Zambia. Obstetr Gynecol. 2011;117(5):1151-9.
Downloads
Published
How to Cite
Issue
Section
