How Can India, Topmost Contributor To Stillbirths In The World, Prevent Fetal Mortality? – News18
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High-quality data in individual records can contribute to better tracking of maternal health issues, such as hypertension, gestational diabetes, infections, and malnutrition, which are linked to stillbirths
Despite being a public health concern, stillbirths have been given less focus in comparison to other health parameters such as maternal and newborn mortalities. (Representative Image)
Stillbirths have been attached to social stigma, with very little support for bereavement. Stillbirths not only have a devastating impact on affected parents and families, but also affect their psychosocial well-being, health and finances.
Despite being a public health concern, stillbirths have been given less focus in comparison to other health parameters such as maternal and newborn mortalities.
A recent Lancet report has released data to address the issue of stillbirth epidemiology in India.
Let us understand the burden of the stillbirths in India, the medical impact on women and its prevention.
What Are Stillbirths?
Stillbirths are one of the common outcomes of pregnancies. A fetal death is defined as a baby who was born with no life signs (did not cry, breathe, or have a heartbeat) either before (antepartum) or after delivery (postpartum).
In India, a stillbirth is defined as a baby born without signs of life at 28 weeks or more of gestation. The stillbirth rate is the number of babies born without signs of life at 28 weeks or more of gestation per 1,000 total births.
The Global Burden of Disease study has estimated 567,000 stillbirths at ≥20 weeks gestation and 397,300 at ≥28 weeks gestation in India in 2021, the highest globally.
Although stillbirths have declined in India, but the pace of reduction is low.
India has committed to single-digit stillbirth rate towards the commitment to the Global Every Newborn Action Plan (ENAP), which seeks to reduce the ≥28 weeks gestation period stillbirth rate to fewer than 12 per 1000 births by 2030.
What Are The Causes And Risks Of Stillbirths In India?
A common barrier in understanding the data on stillbirths is poor availability of clinical data across the continuum of care for pregnant women, which is well highlighted by the dependence on mother’s self-report in surveys for the limited consequent understanding.
A majority of stillbirths are preventable. About 25% of stillbirths are due to maternal health disorders such as anaemia, malnutrition, lifestyle diseases and extremes of age. About 20% of foetal deaths are due to congenital defects or improper foetal growth, and 13% are due to placental diseases.
There are still 20% of stillbirth cases, which have “unexplained” or “undetected” causes, highlighting the need for a scientific process to analyse stillbirths.
Other causes of stillbirth incidence include rural residential status, low socio-economic strata, and poor utilisation of antenatal care, as per a report by The Hindu.
Impact Of Stillbirths On Mothers
Women and their partners who experience stillbirth suffer from higher rates of depression, anxiety and other psychological symptoms that may be long lasting.
This may not only impact parents’ outlook towards life and death, but also destroys their self-esteem and identity. Many women who experience a stillbirth may socially isolate themselves. Negative psychological effects can continue into subsequent pregnancies, even following the birth of a healthy child.
Besides, stillbirths could significant bring down a family’s finances, requiring more resources during perinatal period and in subsequent frequencies.
A stillbirth can have a significant long-term impact on a woman’s reproductive health. Women with stillbirths have an almost five-fold higher risk of having another stillbirth in a subsequent pregnancy and are at an increased risk of other pregnancy complications.
How To Prevent Stillbirths In India
The effort by the Indian Council of Medical Research (ICMR) to address data challenges in epidemiology of stillbirths, diagnosis and prevention, and health system is gaining momentum. Such investments can address the socio-economic bottlenecks and cultural taboos that contribute to stillbirth rates.
High-quality data in individual records can contribute to better tracking of maternal health issues, such as hypertension, gestational diabetes, infections, and malnutrition, often linked to poor pregnancy outcomes, including stillbirths, according to an article by Science Direct.
By harnessing accurate and comprehensive data, India can take significant steps towards preventing stillbirths, enhancing maternal and neonatal health, and achieving its global health commitments, according to an article by BMJ Global Health.
Medical experts suggest preventive measures such as periconceptional folic acid supplementation, early detection of infections such as syphilis and malaria, diabetes management and detection of hypertensive disorders during pregnancy, intrapartum care, judicious family planning and nutritional diet.
A paediatrician or neonatologist should evaluate diseases in the baby; a pathologist and microbiologist along with the obstetrician should study the placenta, according to The Hindu report.
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