Higher stillbirth rates among urban mothers with hotspots in north India: Lancet study

India Today

4 days ago

Stillbirths in India: New study finds higher rates among urban mothers, hotspots in the northIn 2020, more than six out of every 1,000 births in India could have ended in a stillbirth, a new analysis has found — with the rate being higher among urban mothers than rural ones. The research, published in The Lancet Regional Health Southeast Asia journal, also highlights that stillbirth 'hotspots' are largely concentrated in northern and central India.advertisementThe study was conducted by researchers from the All India Institute of Medical Sciences (AIIMS), Gorakhpur, and the Indian Council of Medical Research (ICMR), New Delhi. They examined data from the fifth round of the National Family Health Survey (NFHS-5) and the Civil Registration System (CRS) for 2020 — the latter managed by the Ministry of Home Affairs to record births, deaths, and stillbirths.
Where are the highest stillbirth rates?According to the findings, Chandigarh, Jammu and Kashmir, and Rajasthan recorded the highest stillbirth rates in north India. Nationally, the stillbirth rate (SBR) in 2020 stood at 6.548 per 1,000 total births. When broken down by gender, the rate was 6.54 for female births and 6.63 for male births.Interestingly, the researchers noted that the risk was greater in urban mothers compared to rural ones — a finding that challenges the usual assumption that rural pregnancies face higher risks due to limited healthcare access.Why are stillbirths happening?The analysis pointed to several risk factors. In districts where pregnant women were anaemic (low in iron) or underweight, stillbirth rates were higher. These conditions are known to increase the likelihood of adverse birth outcomes, including stillbirth.On the other hand, districts where more women practised hygienic menstrual care and underwent caesarean (C-section) deliveries saw lower stillbirth rates. This was particularly evident in states like Telangana, Karnataka, and Tamil Nadu, where the rate of C-section deliveries in 2019-20 was around 45%, according to NFHS-5 data.Role of prenatal careThe study also reinforced the importance of prenatal check-ups and nutritional supplementation. Evidence from states such as Assam, Meghalaya, Maharashtra, Uttar Pradesh, Himachal Pradesh, and Chhattisgarh showed that women who received at least four antenatal visits and consistently took iron and folic acid supplements during pregnancy had a significantly lower risk of stillbirth.Socio-economic and healthcare linksResearchers found that higher stillbirth rates were linked to regions where:More deliveries occurred in public health facilitiesWomen had lower wealth statusThere was a higher prevalence of anaemia in pregnant womenWhile male foetuses showed a slightly higher stillbirth rate than female foetuses, the researchers did not find significant gender-based disparities across districts. This slight difference, they suggest, could point to a possible biological vulnerability in male foetuses.advertisementThe study makes it clear that stillbirth is not just a rural health issue — urban mothers, too, are at risk. Improving maternal nutrition, increasing access to quality antenatal care, and ensuring timely medical interventions could play a crucial role in preventing stillbirths across India.- Ends