Factors associated with stillbirth in selected countries of South Asia: A systematic review of observational studies

Abstract

Background Despite having the high rate of stillbirth in most of the countries of South Asia, there is a lack of synthesized evidence based on factors associated with stillbirth. This study systematically synthesizes the evidence on factors associated with stillbirth in the four selected countries of South Asia. Methods This review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies that examined factors associated with stillbirth in South Asia were searched using five major electronic search databases including MEDLINE, CINAHL, Embase, PsycINFO, and Scopus, published between January 2000 and December 2019. In the meta-analysis, significant heterogeneity was detected among studies (I 2 >50%), and hence a random effect model was used. Results A total of 20 studies met the inclusion criteria. The pooled rate of stillbirth from the studies in Bangladesh, India, Nepal, and Pakistan was 25.15 per 1000 births. Pregnancy complications, maternal health conditions, fetal complications, lack of antenatal care, and lower Socio Economic Status (SES) were the most common factors associated with stillbirth in countries of South Asia. Conclusion This study confirmed that stillbirth in selected countries of South Asia remains high. To reduce stillbirth, a greater focus needs to be on timely management of preterm labor, maternal hypertension, and provision of financial support for quality antenatal and delivery care. The interventions should be targeted for women living in remote areas, who are less educated and those with low SES.

Stillbirths among Pregnant Women Admitted to Department of Obstetrics in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…[6][7][8] Additionally, 57% and 50.7% of stillbirths were observed in primiparous mothers in some studies. [16][17][18][19] The percentage of primiparous mothers with stillbirths in the present study is very close to some other studies. [19][20][21] In our study, 60.3% of stillborn babies were preterm.…”

“…[13][14][15] Compared to available studies on stillbirth, the incidence of stillbirth found in this study is possibly the highest compared to other South Asian countries. 16 It is found that stillbirth is more common among mothers aged 20-25 years (43.65%) in this study. Nearly 70% of stillbirths occurred among mothers aged between 20-35 years.…”

Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review

“…Evidence suggests that the prevalence of adverse pregnancy outcomes such as preeclampsia, C-section delivery, macrosomia, low birthweight, still births and IUGR is high in South Asian countries. [15][16][17][18] For example, Poudel et al (2020) 17 reported that the pooled stillbirth rate in India, Bangladesh, Nepal and Pakistan was 25.15 per 1,000 births. Another study reported that, the prevalence of C-section delivery is around 13% in South Asian countries.…”

Measurement and Mapping of Maternal Health Service Coverage Through a Novel Composite Index: A Sub-National Level Analysis in India

“…The time of birth is considered to be extremely crucial for both mother and the child as the chances of complication is high during this stage [10]. Su cient literary evidence supports the prevalence of high-risk pregnancy and pre-term birth among the Indian and other south Asian population [11][12][13][14][15]. Therefore, the delivery of the baby crucially requires an appropriate setting, where lifesaving equipment is available and hygienic conditions are fully maintained.…”