Publication:

Cause of death and associated conditions of stillbirths

Background Fetal death is a psychological trauma for the expecting mother and their family. Most of the countries worldwide lack data on stillbirths. Simply counting stillbirths is the first step in analysis and prevention and hence stillbirths need to count. Purpose of the study is to know the incidence, cause of stillbirths and to plan cause specific interventions to reduce stillbirths.

Methods This is a prospective cross-sectional study of patients with stillbirths from September 2014 to August 2015 in Karnataka Institute of Medical Sciences, Karnataka.  All the cases who delivered stillbirths  of  weight more than 1kg, were  grouped into  the following CODAC (causes of death and associated conditions)  simplified classification and were analysed.

Results The total number of births during the study period was 9,863.  Total number of stillbirths in our study period was 563. In the study period, the stillbirth rate was 57.9 per 1000 births, out of which 56.3% were in preterm pregnancy and 43.69% in term pregnancies. The three common causes of stillbirths were hypertensive disorders (34.63%), intrapartum fetal loss (27.17%) and abruptio placenta (11.54%).  In 7.9% of cases the cause of stillbirth was unknown. Nutritional anaemia, teenage pregnancy and intrauterine growth restriction were the most common associated conditions of stillbirths.

Conclusions Anaemia and teenage pregnancy are the two important risk factors associated with stillbirths. Adolescent health education, folic acid and iron supplementation in schools has to be planned as a primary prevention of stillbirth. Early detection and treatment of hypertensive disorders and good intrapartum care, will help us in reducing the stillbirth rate to a large extent, as these are the two important causes of stillbirth.