Evidence map›Paper›PMID 34373292›Full record

ArticleBMJ open2021

Maternal and fetal characteristics and causes of stillbirth in a tertiary care hospital of Nepal: secondary analysis of registry-based surveillance data.

Basant Sharma, Suraj Bhattarai, Sabita Shrestha, Rakshya Joshi, Renuka Tamrakar, Prekshya Singh, Jully Chaudhary, Upendra Pandit

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Basant SharmaObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.ORCID 0000-0002-8317-5388
Suraj BhattaraiGlobal Health, Global Institute for Interdisciplinary Studies, Kathmandu, Nepal suraj@thegiis.org.ORCID 0000-0001-6843-6677
Sabita ShresthaObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Rakshya JoshiObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Renuka TamrakarObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Prekshya SinghObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Jully ChaudharyObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Upendra PanditObstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Nepal.
Chitwan Medical College · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesStillbirth is one of the vital indicators of quality care. This study aimed to determine maternal-fetal characteristics and causes of stillbirth in Nepal.

designSecondary analysis of single-centred registry-based surveillance data.

settingThe study was conducted at the Department of Obstetrics and Gynecology, Chitwan Medical College Teaching Hospital, a tertiary care hospital located in Bharatpur, Nepal.

participantsAll deliveries of intrauterine fetal death, at or beyond 22 weeks' period of gestation and/or birth weight of 500 g or more, conducted between 16 July 2017 and 15 July 2019 were included in the study.

main outcome measuresThe primary outcome measure of this study was stillbirth, and the secondary outcome measures were maternal and fetal characteristics and cause of stillbirth.

resultsOut of 5282 institutional deliveries conducted over 2 years, 79 (1.5%) were stillbirths, which gives the stillbirth rate of 15 per 1000 births. Of them, the majority (75; 94.9%) were vaginal delivery and only four (5.1%) were caesarean section (p<0.0001). The proportion of the macerated type of stillbirth was more than that of the fresh type (58.2% vs 41.8%; p=0.13). Only half of the mothers who experienced stillbirth had received antenatal care. While the cause of fetal death was unknown in one-third of cases (31.6%; 25/79), among likely causes, the most common was maternal hypertension (29.1%), followed by intrauterine infection (8.9%) and fetal malpresentation (7.6%). Four out of 79 stillbirths (5%) had a birth defect.

conclusionHigh rate of stillbirths in Nepal could be due to the lack of quality antenatal care. The country's health systems should be strengthened so that pregnancy-related risks such as maternal hypertension and infections are identified early on. Upgrading mothers' hygiene and health awareness is equally crucial in reducing fetal deaths in low-resource settings.

Indexed as

Prenatal CareStillbirthCesarean SectionFemaleHumansNepalPregnancyRegistriesTertiary Care Centersfetal medicinematernal medicineperinatologypublic health

Identifiers

PMID34373292
PMCPMC8354277
OpenAlexW3188391167

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.