Stillbirth Rate, Feto-Maternal Characteristics and Geographical Distribution at a Tertiary Care Centre in Assam: A Hospital-Based Retrospective Cross-Sectional Study

Abstract

Background: The global burden of stillbirths is a significant public health concern, with an estimated 1.9 million babies stillborn annually. India faces a remarkably severe crisis with 397,300 stillbirths reported in 2021. The objectives were to determine the stillbirth rate, analyse feto-maternal characteristics and geographical distribution of stillbirth in a tertiary care centre in Assam. Methodology: A retrospective cross-sectional study recruiting 506 subjects, using hospital records at Obstetrics and Gynaecology Department, Gauhati Medical College and Hospital (GMCH), Assam in the year 2024. Inclusion criteria were stillbirths ≥ 28 weeks or ≥ 1000gm birth weight, as per WHO definition. Analysis was done by summarising categorical variables as proportions and percentages. Chi-Square test was used to analyse relationship between district distribution and type of stillbirth. Results: The stillbirth rate was 37.72/1000 births. Of the 506 women, 38 had some pre-existing chronic illnesses, such as chronic hypertension (n=3), diabetes mellitus (n=9), thyroid disorder (n=11) uterine anomaly (n=4), systemic lupus erythematosus (SLE) and heart disease (n=4). The most common cause according to ReCoDe classification was fetal growth restriction (FGR) (n= 124). Most women were of rural residence (n= 415, 82.01%) and maximum referrals were from Kamrup Rural. No significant statistical relation was seen between district distribution and type of stillbirth. Conclusions: Despite improving government healthcare measures, the stillbirth rate has not declined substantially, highlighting gaps in maternal and perinatal care. Understanding stillbirth rates and their geographical distribution can help identify high-risk areas, guide targeted interventions, and improve healthcare delivery.