Stillbirths in a referral medical college hospital, West Bengal, India: a ten-year review.

Aim: To evaluate the stillbirth rate, its major demographic and obstetric risk factors and its trend in a referral teaching hospital.

Material And Methods: A hospital-based cross-sectional retrospective study of stillbirths was done among all deliveries over a decade from January 1999 to December 2008. The stillbirth rate and its changing trends over 10years were evaluated and its associated risk factors were also assessed.

Results: The stillbirth rate in the present study decreased from 44.87 per 1000 total births in 1999-2003 to 24.15 per 1000 total births in 2004-2008. Maternal age over 35 years, pregnant women having parity≥4, lower socioeconomic status and poor antenatal check up were responsible for highest number of stillbirths. Other associated risk factors responsible for stillbirths were antepartum hemorrhage (8.35%), medical diseases of mother (8.00%), severe prematurity (7.34%), birth trauma (3.12%) and intrapartum asphyxia (16.73%). Thirty-six percent of the stillbirths occurred at term and 27% at 34-36 weeks of pregnancy. Only 2% of fetuses had congenital anomalies. Incidence of fresh stillbirth was high. Lower segment cesarean section rate was 16%.

Conclusion: Poor antenatal check-up, lower socioeconomic status and weak referral facilities were the major factors responsible for stillbirths. Most of the stillbirths were preventable by improving women's education and compliance to antenatal care. So proper antenatal care, prompt referral services and availability of emergency obstetric care will provide a pivotal role for reduction of stillbirths.