Analysis of risk factors of stillbirth: a hospital based study in a tertiary care centre

Authors

  • Paresh Shyam Department of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh, Assam, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20160403

Keywords:

Stillbirth, Risk factors, Gestational age

Abstract

Background: Stillbirth is an indicator of maternal health and maternal health care services. Developing countries have high stillbirth rate. Documentation and evaluation of the risk factors for stillbirth is required for management of the risk factors and to devise plan in maternal health sector.

Methods: It was a hospital based retrospective study carried out in a tertiary care hospital. Inclusion criteria were a case of fetal death with gestational age ≥20 weeks or fetal weight ≥ 500gm.

Results: Total birth during the study period was 5132 and stillbirth 282. Stillbirth rate was 5.4% (54/1000). Majority of patients were primigravida (52.59%). Risk factors were detected in 164 (60.74%). Incidence of some of the risk factors were hypertensive disorder of pregnancy 46 (17.03%), antepartum haemorrhage 33 (12.22%), IUGR 11 (4.07%), Malpresentation 15 (5.55%) and fetal anomalies 4 (1.48%). Stillbirth without risk factors was 106 (39.25%).

Conclusion: Majority of the risk factors found in the present study were preventable. Stillbirth rate can be reduced by proper management of these risk factors during antenatal care and intrapartum care.

References

Kowaleski J. State definitions and reporting requirements for live births, fetal deaths, and induced terminations of pregnancy. Hyattsville, Maryland: National Center for Health Statistics. 1997. Available at: http://www.cdc.gov/nchs/data/misc/itop97.pdf. Assessed 30 December 2015.

http://www.who.int/maternal_child_adolescent/epidemiology/stillbirth/en. Assessed 30 December 2015.

https://data.gov.in/resources/still-birth-rate-india-2011/download. Assessed 30 December 2015.

Ha YP, Hurt LS, Tawiah-Agyemang C, Kirkwood BR, Edmond KM. Effect of Socioeconomic Deprivation and Health Service Utilisation on Antepartum and Intrapartum Stillbirth: Population Cohort Study from Rural Ghana. Plos one. 2012;7(7):e39050. doi:10.1371/journal.pone.0039050

Carmichael SL, Blumenfeld YJ, Mayo J, Wei E, Gould JB, Stevenson DK. Prepregnancy Obesity and Risks of Stillbirth. Plos one. 2015;10(10).

Aminu M, Unkels R, Mdegela M, Utz B, Adaji S, van den Broek N. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG. 2014;121(4):141-53.

DeFranco E, Hall E, Hossain M, Chen A, Haynes EN, Jones D. Air Pollution and Stillbirth Risk: Exposure to Airborne Particulate Matter during Pregnancy Is Associated with Fetal Death. Plos one. 2015;10(3):e0120594.

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(2):53.

Bukowski R, Hansen NI, Willinger M, Reddy UM, Parker CB. Fetal Growth and Risk of Stillbirth: A Population-Based Case–Control Study. PLoS Med. 2014;11(4):e1001633.

Helgadóttir LB, Turowski G, Skjeldestad FE, Jacobsen AF, Sandset PM, Roald B, et al. Intrauterine fetal death: classification and risk factors A case-control study of sociodemographic, clinical and thrombophilic risk factors. Acta Obstetricia et Gynecologica Scandinavica. 2013;92(3):325-33.

Liu, Li-Chun, Huang, Han-Bin Yu, Mu-Hsien Su. Her-Young Analysis of intrauterine fetal demise--a hospital-based study in Taiwan over a decade. Taiwanese journal of obstetrics & gynecology. 2013;52:546e550.

Patel S, Thaker R, Shah P, Majumder S. Study of causes and complications of intra uterine fetal death (IUFD). Int J Reprod Contracept Obstet Gynecol. 2014;3:931-5.

Nayak SR, Garg N. Determinations of antepartum fetal death J Obstet Gynecol India. 2010;60(6):494-7.

Singh N, Pandey K, Gupta N, Arya AK, Pratap C, Naik R. A retrospective study of 296 cases of intra uterine fetal deaths at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2013;2:141-6.

Avachat SS, Phalke DB, Phalke VD. Risk factors associated with stillbirths in the rural area of Western Maharashtra, India. Arch Med Health Sci. 2015;3:56-9.

Choudhary A, Gupta V. Epidemiology of Intrauterine Fetal Deaths: A Study in Tertiary Referral Centre In Uttarakhand. IOSR-Journal Dental and Medical Science. 2014;13(3):03-6.

Tamrakar SR, Chawla CD. Intrauterine Foetal Death and its Probable Causes: Two year Experience in Dhulikhel Hospital – Kathmandu University Hospital. Kathmandu Univ med J. 2012;10(4):44-8.

Gray R, Quigley M, Hockley C, Kurinczuk J, Goldacre M, Brocklehurst P. Caesarean delivery and risk of stillbirth in subsequent pregnancy: a retrospective cohort study in an English population. BJOG. 2007;114:264-70.

Wood S, Chen S, Ross S, Sauve R. The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy. BJOG. 2008;115:726-31.

Wood S, Ross S, Sauve R. Cesarean Section and Subsequent Stillbirth, Is Confounding by Indication Responsible for the Apparent Association? An Updated Cohort Analysis of a Large Perinatal Database. Plos one. 2015;10(9):e0136272.

Downloads

Published

2016-12-17

Issue

Section

Original Research Articles