Evaluation of Risk Factors Associated with Stillbirth in a Tertiary Level Hospital.

Abstract

A Stillbirth is the birth of a newborn after 28th completed week (weighing 1000 gm or more) when the baby does not breathe or show any signs of life after delivery. It has an enormous impact on mothers, families, health care professionals and the community. Bangladesh has high stillbirth rate due to lack of access to antenatal care, home trial, high parity, social norms and customs etc. Multiple maternal and fetal risk factors have been identified that are associated with stillbirth. This study is intended to provide information for proper antepartum surveillance and also build up awareness in the community to prevent perinatal mortality. Objective of this study was evaluation of risk factors associated with stillbirth. This was cross-sectional observational study conducted from 10th February 2019 to 10th August 2019. Consecutive 100 pregnant women admitted in Obstetrics and Gynaecology department of MMCH and had delivered stillbirth baby were included in the study. Data was collected through a pre-designed questionnaire and analyzed by SPSS Version 26.0. In this study, 76.0% women were found between 20 to 30 years of age. Most of the women studied were gravida second and third (72.0%). Most stillbirth baby were preterm with gestational age between 35 to 36 weeks (60.0%). Maternal hypertensive disorder was the commonest medical disorder associated with stillbirth (34.0%), followed by DM (6.0%). Obstetric complications associated with stillbirth were PROM (12.0%), prolonged labour (8.0%), obstructed labour (5.0%), abruptio placentae (6.0%), placenta praevia (2.0%) and cord accident (6.0%). Fetal factor accounted for 8.0% of stillbirth of which majority was due to multiple congenital anomalies (6.0%). Apparently no identifiable risk factors were found in 8.0% cases. It was observed that maternal hypertensive disorders were the predominant risk factors of stillbirth. Majority of women had emergency admission and did not receive adequate antenatal care at all. Significant proportion of stillbirth was preventable by proper and regular antenatal checkup, timely referral and hospital delivery.