Singh Abha, Kumar Manisha
Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, 110001 India.
J Obstet Gynaecol India. 2019 Apr;69(2):155-160. doi: 10.1007/s13224-018-1161-1. Epub 2018 Aug 10.
Over 98% of the world's total stillbirths are believed to occur in developing countries and still have received very little research, programmatic or policy attention.
To collect data on epidemiological profile of cases experiencing stillbirths, to assess the associated antenatal high risk factors present and to find out the probable cause of stillbirth.
This was a cross-sectional, observational study, which was done as part of WHO SEARO project after ethical clearance. The study included all stillbirths which occurred in the hospital during the study period August 2015-February 2017. Antenatal records were reviewed; maternal investigations were done. Baby was examined after delivery. Pre-structured pro forma was filled for every case. Finally, the relevant condition found was classified under CODAC system of stillbirth classification.
Out of 20,580 deliveries, 600 (2.9%) were stillborn. Maternal cause was noted in 145/600 (24.2%) cases, fetal cause was noted in 181/600 (30.2%), and placental and cord origins were suspected in 128/600 (21.3%) and 12/600 (2%) cases, respectively. In 72/600 (12.0%) cases the reason for stillbirth was unknown and unclassifiable. Among the maternal causes the most common was hypertension (89/600, 14.8%) followed by infection including fever (5.7%); the most common infection was hepatitis. Among the fetal causes birth defect was the most common (106/600, 17.7%) followed by extreme prematurity in 42/600 (7.0%).
Birth defects were the most important fetal cause of stillbirth; hypertension in pregnancy and fetal growth restriction were important associated factors.
据信，全球超过98%的死产发生在发展中国家，且仍未得到足够的研究、项目或政策关注。
收集死产病例的流行病学资料，评估相关的产前高危因素，并找出死产的可能原因。
这是一项横断面观察性研究，在获得伦理批准后作为世卫组织东南亚区域办事处项目的一部分开展。该研究纳入了2015年8月至2017年2月研究期间在医院发生的所有死产病例。查阅产前记录；进行母体检查。分娩后对婴儿进行检查。为每个病例填写预先构建的表格。最后，根据死产分类的CODAC系统对发现的相关情况进行分类。
在20580例分娩中，有600例（2.9%）为死产。145/600例（24.2%）的死产原因是母体因素，181/600例（30.2%）是胎儿因素，128/600例（21.3%）和12/600例（2%）分别怀疑是胎盘和脐带原因。72/600例（12.0%）的死产原因不明且无法分类。在母体因素中，最常见的是高血压（89/600，14.8%），其次是包括发热在内的感染（5.7%）；最常见的感染是肝炎。在胎儿因素中，出生缺陷最为常见（106/600，17.7%），其次是极早产，为42/600例（7.0%）。
出生缺陷是死产最重要的胎儿因素；妊娠期高血压和胎儿生长受限是重要的相关因素。
