Socioeconomic deprivation as a risk factor for stillbirth: A case-control study

Stillbirth is a devastating outcome for families. Identifying and addressing risk factors is of crucial importance. Level of deprivation has been linked to adverse perinatal outcomes, including stillbirth.

An observational case-control study was conducted, matching cases of stillbirth (n = 127) with a control cohort of live births (n = 266, ratio 2:1). Retrospective data on maternal characteristics, pregnancy details and neonatal outcomes from 2018-2021 was collected from a tertiary maternity unit in the Republic of Ireland. The Pobal HP Deprivation Index was used to categorise small areas into levels of deprivation. Maternal age, parity, BMI, booking visit gestation were considered potential confounding factors. Statistical analysis using SPSS, included: descriptive statistics, Chi-squared tests, T-tests. Logistic regression for crude and multivariate analysis, including odds ratio calculations, were used to identify differences in risk of stillbirth across the deprivation levels and categories of confounding factors.

The results demonstrated no statistically significant correlation between level of deprivation and risk of having a stillbirth (p = 0.288) in this sample. When readjusted into quintiles of deprivation, a slightly higher representation of stillbirth was noted in the more deprived levels, though not statistically significant. When examining by cause of death, there was a significant association between deprivation and placental causes of death (p = 0.048). High BMI was consistently associated with stillbirth, while late booking visit gestation and advanced maternal age also showed associations.

This study found no clear link between deprivation and stillbirth but observed higher placental-related stillbirth in deprived quintiles, emphasising the need for further national research.