Mukherjee Reema
Reproductive and Child Health, Indian Council of Medical Research, New Delhi, India
BMJ Open. 2025 Aug 25;15(8):e099401. doi: 10.1136/bmjopen-2025-099401.
PURPOSE: Stillbirth is a significant public health problem in India, yet comprehensive epidemiological data on its prevalence and risk factors are lacking. The objectives of this research were to develop a dataset pooled from 10 well-characterised pregnancy cohorts across urban and rural India to estimate the prevalence of stillbirths, identify and quantify risk factors and develop a predictive risk stratification model for evidence-based clinical decision-making in high-risk pregnancies. PARTICIPANTS: Pregnant women were enrolled during the antenatal period in 10 existing cohorts across India. Enrolment occurred through either health facilities or community settings at four urban, four rural and two mixed urban-rural sites spanning nine states. All participants were enrolled before childbirth, with follow-up completed at least until delivery. FINDINGS TO DATE: The Indian Council of Medical Research (ICMR) stillbirth pooled India cohort (ICMR-Stillbirth Pooled India Cohort Dataset (SPIC)) comprises 229 695 pregnant women. The mean (SD) maternal age at recruitment was 24.8 (4.5) years. 22.2% were underweight (body mass index (BMI)<18.5 kg/m²) and 16.6% were overweight or obese (BMI≥23 kg/m²). Short stature (<145 cm) was observed in 6.9% of participants. The mean (SD) gestational age at birth was 38.4 (2.1) weeks. One-third of the participants (33.3%) experienced moderate-to-severe anaemia during pregnancy (haemoglobin<95 g/L), 52.8% were multiparous and 27.6% conceived within 18 months of their previous childbirth. Core maternal risk factors such as short stature, BMI, parity, prior stillbirths and anaemia during pregnancy were recorded in all cohorts. Additional variables, including gestational weight gain, pre-eclampsia/eclampsia, antepartum haemorrhage and fetal distress, were available for over 80% of the cohorts, ensuring robust data coverage for risk factor analysis and modelling. FUTURE PLANS: ICMR-SPIC will be used to conduct individual-level pooled data analyses to estimate prevalence, identify key risk factors and develop predictive models for stillbirths. Findings will inform policies, clinical guidelines and targeted interventions for high-risk pregnancies. The harmonised ICMR-SPIC dataset is a landmark collaborative effort to advance maternal and newborn health in India.
目的：死产在印度是一个重大的公共卫生问题，但缺乏关于其患病率和风险因素的全面流行病学数据。本研究的目的是建立一个数据集，该数据集汇集了印度城乡10个特征明确的妊娠队列，以估计死产的患病率，识别和量化风险因素，并开发一个预测风险分层模型，用于高危妊娠的循证临床决策。 参与者：印度各地10个现有队列的孕妇在孕期登记入组。登记通过九个邦的四个城市、四个农村和两个城乡结合部的卫生机构或社区进行。所有参与者均在分娩前登记入组，随访至少持续到分娩。 迄今的发现：印度医学研究理事会（ICMR）死产合并印度队列（ICMR-死产合并印度队列数据集（SPIC））包括229695名孕妇。招募时孕妇的平均（标准差）年龄为24.8（4.5）岁。22.2%的孕妇体重过轻（体重指数（BMI）<18.5kg/m²），16.6%的孕妇超重或肥胖（BMI≥23kg/m²）。6.9%的参与者身材矮小（<145cm）。出生时的平均（标准差）孕周为38.4（2.1）周。三分之一的参与者（33.3%）在孕期经历了中度至重度贫血（血红蛋白<95g/L），52.8%为经产妇，27.6%在之前分娩后18个月内怀孕。所有队列都记录了身材矮小、BMI、产次、既往死产和孕期贫血等核心孕产妇风险因素。超过80%的队列提供了包括孕期体重增加、先兆子痫/子痫、产前出血和胎儿窘迫等额外变量，确保了风险因素分析和建模有强大的数据覆盖。 未来计划：ICMR-SPIC将用于进行个体水平的汇总数据分析，以估计患病率、识别关键风险因素并开发死产预测模型。研究结果将为高危妊娠的政策、临床指南和针对性干预提供依据。统一的ICMR-SPIC数据集是推进印度孕产妇和新生儿健康的一项具有里程碑意义的合作成果。
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