Covid-19 saw increased stillbirth rates in India

The first population-based study from India that aims at highlighting the magnitude of increase in stillbirth rates (SBR) during the COVID-19 pandemic has found that there was a statistically significant increase of 24.3% and 68.9% in overall SBR and intrapartum (during childbirth) SBR seen between 2016 and 2020–2021, respectively. Stillbirth is defined as fetal death with a gestation period of seven months or more where the fetus did not show any sign of life.

According to the study, the risk factor associations for stillbirths were similar between the COVID-19 peak and non-peak periods, with gestation age of less than 8 months with the highest odds of stillbirth followed by referred deliveries and deliveries in private health facilities. The study documents an increase in SBR during the COVID-19 pandemic as compared with the pre-pandemic period, and the varied SBR based on the intensity of the COVID-19 pandemic and by the place of delivery.

The study, conducted by a team of researchers led by Dr Rakhi Dandona of Public Health Research Foundation of India (PHFI) and the Institute for Health Metrics and Evaluation, University of Washington, USA, arrives at the conclusion after analyzing the births between July 2020 and June 2021 (91.5% participation) in the State of Bihar. Published in BMJ Global Health, the study identifies 582 stillbirths in 30,412 births with an estimated SBR of 19.1 per 1000 births. The SBR was found to be significantly higher in private facilities than in public facility births and for COVID-19 peak than non-peak period births.

"The COVID-19 pandemic has potentially derailed on-track efforts to achieve the Sustainable Development Goals by 2030, especially for maternal and neonatal survival including stillbirth prevention, and urgent efforts are needed to build stronger health systems after the pandemic. In addition to documenting the extent of increase in stillbirths as a result of the pandemic, our study findings highlight the opportunities and challenges of private sector delivery of maternal and newborn care as a result of the pandemic, and the need to accelerate improvements in quality of labour and delivery care in the public sector facilities. It also adds to the call on strengthening death registration systems around the world, which is crucial to global public health strategy and necessary for improved monitoring of this pandemic and future pandemics," the study concludes.