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VOLUME 16 , ISSUE 3 ( May-June, 2024 ) > List of Articles

Original Article

Antenatal Care: Is It Really a Modifiable Factor for Stillbirth Prevention?

Nishi Choudhary

Keywords : Antenatal care, Stillbirth, Unbooked pregnancy

Citation Information : Choudhary N. Antenatal Care: Is It Really a Modifiable Factor for Stillbirth Prevention?. J South Asian Feder Obs Gynae 2024; 16 (3):214-218.

DOI: 10.5005/jp-journals-10006-2277

License: CC BY-NC 4.0

Published Online: 29-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Stillbirth is a major cause of perinatal death in India. Deciphering the cause of stillbirth will help in formulating prevention strategies to bring down the stillbirth rate. Our objective is to explore the antepartum and intrapartum causes and risk factors of stillbirths. Materials and methods: This was a prospective observational study done under WHO-SEARO project. This study included all stillbirths occurring in Safdarjung Hospital from August 2015 to December 2018. Verbal autopsies were done, and thorough antenatal records were documented and analyzed. Results: Out of 1,09,578 deliveries, 2,689 were stillbirths (2.4%). Among these, 1,583 (58.9%) were unsupervised and unbooked pregnancies, whereas 1,106 (41.1%) pregnancies were supervised and booked. Significantly lower percentage of patients in unbooked pregnancies had iron–folic acid intake; significantly higher percentage of mothers had anemia, hypertension, diabetes, and antepartum hemorrhage compared with booked pregnancies. Among antepartum causes, hypertension (23.4%), abruption (18.5%), and infection (3.4%) were the leading causes for stillbirths. Intrapartum causes constituted 39% of total stillbirths; a higher percentage was in the unbooked pregnancies. Approximately, 89% of patients with stillbirth had delayed seeking of healthcare facility. Conclusion: The most common cause of stillbirth was hypertensive disorders of pregnancy followed by abruptio placentae in this cohort. Various maternal-related factors are significantly higher in unbooked pregnancies. Reducing these factors might reduce the prevalence of stillbirth.

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  1. McClure EM, Nalubamba-Phiri M, Goldenberg RL. Stillbirth in developing countries. Int J Gynecol Obstet 2006;94(2):82–90. DOI: 10.1016/j.ijgo.2006.03.023.
  2. Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet Lond Engl 2016;387(10018): 587–603. DOI: 10.1016/S0140-6736(15)00837-5.
  3. Blencowe H, Cousens S, Jassir FB, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 2016;4(2):e98–108. DOI: 10.1016/S2214-109X(15)00275-2.
  4. Lawn JE, Blencowe H, Pattinson R, et al. Stillbirths: Where? When? Why? How to make the data count? Lancet Lond Engl 2011;377(9775):1448–1463. DOI: 10.1016/S0140-6736(10)62187-3.
  5. Europe WHORO for. Definitions and indicators in Family Planning Maternal & Child Health and Reproductive Health used in the WHO Regional Office for Europe. 2000 [cited 2020 May 3]; Available from: https://apps.who.int/iris/handle/10665/108284.
  6. de Bernis L, Kinney MV, Stones W, et al. Stillbirths: ending preventable deaths by 2030. Lancet Lond Engl. 2016;387(10019):703–716. DOI: 10.1016/S0140-6736(15)00954-X.
  7. Pattinson R, Kerber K, Waiswa P, et al. Perinatal mortality audit: counting, accountability, and overcoming challenges in scaling up in low- and middle-income countries. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 2009;107 Suppl 1:S113–121, S121-122. DOI: 10.1016/j.ijgo.2009.07.011.
  8. Villar J, Ba'aqeel H, Piaggio G, et al. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet Lond Engl 2001;357(9268):1551–1564. DOI: 10.1016/s0140-6736(00)04722-x.
  9. Frøen JF, Pinar H, Flenady V, et al. Causes of death and associated conditions (Codac) – a utilitarian approach to the classification of perinatal deaths. BMC Pregnancy Childbirth 2009;9(1):22. DOI: 10.1186/1471-2393-9-22.
  10. SOIN_PRINTED 14-9-2014.pdf [Internet]. [cited 2020 3]. Available from: https://www.newbornwhocc.org/SOIN_PRINTED%2014-9-2014.pdf.
  11. Ashish KC, Nelin V, Wrammert J, et al. Risk factors for antepartum stillbirth: a case-control study in Nepal. BMC Pregnancy Childbirth 2015;15:146. DOI: 10.1186/s12884-015-0567-3.
  12. Lavin T, Pattinson R. Does antenatal care timing influence stillbirth risk in the third trimester? A secondary analysis of perinatal death audit data in South Africa. BJOG Int J Obstet Gynaecol 2018;125(2):140–147. DOI: 10.1111/1471-0528.14645.
  13. Prasanna N, Mahadevappa K, Antaratani RC, et al. Cause of death and associated conditions of stillbirths. Int J Reprod Contracept Obstet Gynecol 2017;4(6):1970–1974.
  14. Ray JG, Laskin CA. Folic acid and homocyst(e)ine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: a systematic review. Placenta 1999;20(7):519–529. DOI: 10.1053/plac.1999.0417.
  15. Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011;377(9774):1331–1340. DOI: 10.1016/S0140-6736(10)62233-7.
  16. Amark H, Westgren M, Persson M. Prediction of stillbirth in women with overweight or obesity—A register-based cohort study PLOS One 2018;13(11):e0206940. DOI: 10.1371/journal.pone.0206940.
  17. Vidyadhar B B. Review of socio demographic factors and obstetric causes of stillbirths at tertiary care hospital. IOSR J Pharm IOSRPHR 2012;2(3):475–478. DOI:10.9790/3013-0230475478.
  18. Wilkins A, Earnest J, Mccarthy EA, Shub A. A retrospective review of stillbirths at the national hospital in Timor-Leste. Aust N Z J Obstet Gynaecol. 2015;55(4):331–336. DOI: 10.1111/ajo.12337.
  19. 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(1):56-59. DOI: 10.4103/2321-4848.154946
  20. Dudley DJ. Diabetic-associated stillbirth: incidence, pathophysiology, and prevention. Clin Perinatol 2007;34(4):611–626. DOI: 10.1016/j.clp.2007.09.003.
  21. Zhang X, Joseph KS, Cnattingius S, et al. Birth weight differences between preterm stillbirths and live births: analysis of population-based studies from the U.S. and Sweden. BMC Pregnancy Childbirth 2012;12:119. DOI: 10.1186/1471-2393-12-119.
  22. Helgadóttir LB, Turowski G, Skjeldestad FE, et al. Classification of stillbirths and risk factors by cause of death–a case-control study. Acta Obstet Gynecol Scand 2013;92(3):325–333. DOI: 10.1111/aogs.12044.
  23. Bhutta ZA, Yakoob MY, Lawn JE, et al. Stillbirths: what difference can we make and at what cost? Lancet Lond Engl 2011;377(9776):1523–1538. DOI: 10.1016/S0140-6736(10)62269-6.
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