Stillbirth rate and maternal risk factors for antenatal stillbirth in Bihar: A hospital-based cross-sectional study

Monika Gupta¹, Meena Samant¹, Jayoti Malhotra¹

¹Department of Obstetrics and Gynaecology, Kurji Holy Family Hospital, Patna, Bihar, India.

Journal of Family Medicine and Primary Care

|July 29, 2025

Background And Objectives:

The prevalence and risk factors of stillbirths vary across geographical and socioeconomic contexts, extending beyond maternal and fetal factors. Many of these risks are preventable with quality pregnancy care. Prevention relies on recognizing and appropriately addressing these factors.

Methods:

This was a descriptive cross-sectional study done at a referral hospital, Patna, Bihar in 2023-2024. All pregnancies complicated with stillbirths were included. Data regarding demographic details, chief complaints, comorbidities, clinical, and laboratory parameters were collected and analyzed in MS Excel.

Results:

The study involved 5666 deliveries, noting 76 stillbirths (SBR of 13.4/1000 births). Most affected women were aged 25-35 (63%) and from rural areas (70%), with low education (42% up to middle school). Majority belonged to a low socioeconomic class. Few had consanguineous marriages (4%). Primigravida accounted for 52.6%, with inadequate antenatal visits (68%). Stillbirths mostly occurred between 30^th and 37^th weeks and were associated with pregnancy complications like hypertension (19.7%) and oligohydramnios (48.68%). Female fetuses numbered 41, with 50% showing intrauterine growth retardation. Complaints mainly included decreased fetal movement (66%) and abdominal pain (43%), sometimes occurring together (24%).

Conclusion:

The study reveals a higher stillbirth rate despite improved education among lower-income women. Pregnancy-related hypertension is a significant risk factor associated with IUGR. Poor antenatal care, healthcare gaps, and limited awareness in rural areas contribute to hypertension-related complications and stillbirths. High uterine rupture rates likely due to delayed diagnosis highlight the need for improved maternal-fetal health awareness, better rural healthcare, and strong societal and political commitment to pregnancy management goals.

Keywords:

Antenatal intrauterine fetal death maternal pregnancy risk factor stillbirth

Frequently Asked Questions

Based on this study's findings, pregnancy-related hypertension is a significant risk factor that frequently leads to intrauterine growth retardation. This condition was associated with 19.7% of stillbirth cases, contributing to complications that often result in fetal death between the 30th and 37th weeks of gestation.

The researchers identified a stillbirth rate of 13.4 per 1000 births among 5666 deliveries. Clinical data also revealed that 48.68% of these stillbirth cases were complicated by oligohydramnios, a condition characterized by a deficiency in amniotic fluid that negatively impacts fetal development.

The descriptive cross-sectional design allowed the investigators to quantify the stillbirth rate and identify demographic patterns across 76 cases. This methodology enabled the collection of data regarding chief complaints, such as the 66% of women reporting decreased fetal movement, and laboratory parameters like intrauterine growth status.

These findings are primarily confined to women seeking care at a referral hospital in Patna, Bihar, particularly those from rural areas and low socioeconomic classes. The results highlight constraints such as the 68% rate of inadequate antenatal visits, which may not generalize to urban populations with better access.

The study's authors propose that high uterine rupture rates observed in the cohort are likely due to delayed diagnosis. They state that improving maternal-fetal health awareness and rural healthcare infrastructure is essential to prevent these complications and meet regional pregnancy management goals.

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