Research Information System
Journal of Surgery and Medicine, vol.5, no.1, pp.80-84, 2021 (Peer-Reviewed Journal)
Background/Aim: Stillbirth is a devastating complication of the pregnancy. Contemporary studies have
exposed several reasons; however, most of the cases are still unexplained. Stillbirth delivery could cause
various maternal complications. We aimed to evaluate the maternal complications and reveal the risk
factors for stillbirth.
Methods: A case-control study was performed at a high-volume university-affiliated research and
training hospital between June 2016 and June 2020. The study population was divided into two groups as
women who delivered stillbirth (study group) and live birth (control group). Patients’ characteristics, birth
weight and gender of the newborn, hospital stay, delivery type, concomitant diseases in pregnancy such as
preeclampsia, gestational diabetes mellitus, fetal anomaly, preterm premature rupture of the membranes
and complications such as uterine atony, abruptio placenta, postpartum hemorrhage, disseminated
intravascular coagulation, and uterine rupture were evaluated from the medical records and compared
between groups.
Results: A total of 46019 births occurred during the study period. The number of women who delivered
stillbirth was 520 with a rate of 11.2 per 1000 births. The control group included 6521 patients.
Comparison of the groups revealed that women delivering stillbirth were older (P<0.001), had longer
hospital stay (P<0.001), lower newborn birth weight (P<0.001), and more babies with congenital
anomalies (P<0.001) than the control group. The women in stillbirth group experienced more preterm
premature rupture of the membranes (P<0.001), preeclampsia (P<0.001), gestational diabetes mellitus
(P<0.001), abruptio placenta (P<0.001), postpartum hemorrhage (P<0.001), and disseminated
intravascular coagulation (P<0.001). The rates of severe obstetric and postpartum complications were
14.2% and 12.1%, respectively. Multivariate logistic regression analysis revealed that fetal anomaly (OR
3.170; 95% CI 1.592-6.315, P<0.001), gestational diabetes mellitus (OR 15.203; 95% CI 8.368-27.621,
P<0.001) and abruptio placenta (OR 18.221; 95% CI 9.121-36.402, P<0.001) increased the risk of
stillbirth.
Conclusion: Stillbirth delivery could lead to severe maternal complications that can threaten maternal
vitality. Close delivery follow-up is essential, especially during the early postpartum period. Care should
be taken for postpartum complications such as disseminated intravascular coagulation and postpartum
hemorrhage. Furthermore, patients should be examined carefully for abruptio placenta. Stillbirth
deliveries should be carried out in fully equipped hospitals.
Keywords: Abruptio placenta, Gestational diabetes mellitus, Maternal complication, Stillbirth