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Updated: Mar 12, 2026

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Aetiological Classification of Stillbirths: A Case Control Study.

Sonal A Kumbhare1, Nandita K Maitra1

  • 1Department of Obstetrics and Gynaecology, Medical College, Baroda, Gujarat India.

Journal of Obstetrics and Gynaecology of India
|November 9, 2016
PubMed
Summary

The ReCoDe classification system effectively identified causes for 74.1% of stillbirths, with fetal growth restriction being the most common condition. This system aids in understanding stillbirth etiology and reducing unexplained cases.

Keywords:
Birth weightGestational ageIntrauterine growth restrictionReCoDeStillbirths

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Area of Science:

  • Perinatal Medicine
  • Obstetrics
  • Public Health

Background:

  • Antepartum stillbirths significantly contribute to perinatal mortality.
  • Accurate etiological classification of stillbirths is crucial for effective prevention strategies.
  • The ReCoDe (relevant condition at birth) classification system offers a structured approach to evaluating stillbirths.

Purpose of the Study:

  • To assess the utility of the ReCoDe classification system in determining the etiology of stillbirths.
  • To evaluate the role of ReCoDe in a tertiary teaching hospital setting in Central Gujarat.
  • To identify significant risk factors associated with antepartum stillbirths.

Main Methods:

  • A prospective case-control study was conducted over one year (September 2012 - August 2013).
  • 243 stillbirth cases were compared with 486 live birth controls, matched for gestational age and birth weight.
  • Multivariate logistic regression was used to calculate odds ratios and identify independent risk factors.

Main Results:

  • The stillbirth rate was 87.83 per 1000 live births.
  • The ReCoDe system classified the etiology for 74.1% of stillbirths, with 25.9% remaining unexplained.
  • Significant independent risk factors included previous stillbirth, antepartum hemorrhage, hypertensive disorders, major congenital anomalies, birth asphyxia, cord accidents, and uterine rupture.
  • Fetal growth restriction was the most frequent condition identified (25.9%).

Conclusions:

  • The ReCoDe classification system is valuable for determining stillbirth etiology, reducing the proportion of unexplained cases.
  • Identifying specific conditions like fetal growth restriction aids in targeted interventions.
  • The study highlights key risk factors that warrant attention for stillbirth prevention efforts.