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Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India

BACKGROUND: Birth of a fetus with no signs of life after a predefined age of viability is a nightmare for the obstetrician. Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Though there has been a renewed global focus on stillbirth as a public health...

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Autores principales: Mali, Rajshekher V., Dalal, Anita, Khursheed, Romana, Gan, Aditya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324385/
https://www.ncbi.nlm.nih.gov/pubmed/34335785
http://dx.doi.org/10.1155/2021/8033248
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author Mali, Rajshekher V.
Dalal, Anita
Khursheed, Romana
Gan, Aditya
author_facet Mali, Rajshekher V.
Dalal, Anita
Khursheed, Romana
Gan, Aditya
author_sort Mali, Rajshekher V.
collection PubMed
description BACKGROUND: Birth of a fetus with no signs of life after a predefined age of viability is a nightmare for the obstetrician. Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Though there has been a renewed global focus on stillbirth as a public health concern, the decline in stillbirth rate (SBR) has not been satisfactory across the nations, with a large number of stillbirths occurring in the low- to middle-income countries (LMICs). Hence, the study was carried out to analyze maternal and fetal risk factors and their association with stillbirths in a tertiary care center in South India. METHODS: This observational prospective study included pregnant women with stillbirth beyond 20 weeks of gestation or fetal weight more than 500 grams. Stillbirths were classified according to the simplified causes of death and associated conditions (CODAC) classification. Association between the risk factor and stillbirths was calculated with chi-square test and odds ratio with 95% confidence interval. RESULTS: There were 171 stillbirths (2.97%) among total 5755 births. The SBR was 29.71/1000 births. Risk factors such as preterm delivery (OR: 22.33, 95% CI: 15.35–32.50), anemia (OR: 21.87, 95% CI: 15.69–30.48), congenital malformation (OR: 11.24, 95% CI: 6.99–18.06), abruption (OR: 10.14, 95% CI: 6.43–15.97), oligohydramnios (OR: 4.88, 95% CI: 3.23–7.39), and hypertensive disorder (OR: 3.01, 95% CI: 2.03–4.46) were significantly associated with stillbirths. The proportion of intrapartum stillbirths was found to be 5 (3%) among the study population. CONCLUSION: Highest prevalent risk factors associated with stillbirth are anemia and prematurity. Intrapartum stillbirths can be reduced significantly through evidence-based clinical interventions and practices in resource-poor settings. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control the risk factors associated with stillbirths.
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spelling pubmed-83243852021-07-31 Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India Mali, Rajshekher V. Dalal, Anita Khursheed, Romana Gan, Aditya Obstet Gynecol Int Research Article BACKGROUND: Birth of a fetus with no signs of life after a predefined age of viability is a nightmare for the obstetrician. Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Though there has been a renewed global focus on stillbirth as a public health concern, the decline in stillbirth rate (SBR) has not been satisfactory across the nations, with a large number of stillbirths occurring in the low- to middle-income countries (LMICs). Hence, the study was carried out to analyze maternal and fetal risk factors and their association with stillbirths in a tertiary care center in South India. METHODS: This observational prospective study included pregnant women with stillbirth beyond 20 weeks of gestation or fetal weight more than 500 grams. Stillbirths were classified according to the simplified causes of death and associated conditions (CODAC) classification. Association between the risk factor and stillbirths was calculated with chi-square test and odds ratio with 95% confidence interval. RESULTS: There were 171 stillbirths (2.97%) among total 5755 births. The SBR was 29.71/1000 births. Risk factors such as preterm delivery (OR: 22.33, 95% CI: 15.35–32.50), anemia (OR: 21.87, 95% CI: 15.69–30.48), congenital malformation (OR: 11.24, 95% CI: 6.99–18.06), abruption (OR: 10.14, 95% CI: 6.43–15.97), oligohydramnios (OR: 4.88, 95% CI: 3.23–7.39), and hypertensive disorder (OR: 3.01, 95% CI: 2.03–4.46) were significantly associated with stillbirths. The proportion of intrapartum stillbirths was found to be 5 (3%) among the study population. CONCLUSION: Highest prevalent risk factors associated with stillbirth are anemia and prematurity. Intrapartum stillbirths can be reduced significantly through evidence-based clinical interventions and practices in resource-poor settings. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control the risk factors associated with stillbirths. Hindawi 2021-07-22 /pmc/articles/PMC8324385/ /pubmed/34335785 http://dx.doi.org/10.1155/2021/8033248 Text en Copyright © 2021 Rajshekher V. Mali et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mali, Rajshekher V.
Dalal, Anita
Khursheed, Romana
Gan, Aditya
Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title_full Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title_fullStr Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title_full_unstemmed Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title_short Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India
title_sort association of stillbirths with maternal and fetal risk factors in a tertiary care hospital in south india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324385/
https://www.ncbi.nlm.nih.gov/pubmed/34335785
http://dx.doi.org/10.1155/2021/8033248
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