Understanding stillbirth etiology in LMICs is paramount for achieving Sustainable Development Goal 3.2. Despite global initiatives, the progress in reducing stillbirth rates has lagged behind neonatal and maternal mortality reductions. This research addresses critical gaps in the literature by focusing on the intersection of infectious diseases and systemic healthcare deficiencies. By identifying specific, measurable risk factors, this study provides healthcare providers and policymakers with the data necessary to allocate resources effectively. The relevance extends beyond clinical settings to national health strategic planning, offering a roadmap for implementing life-saving maternal interventions. Furthermore, the focus on resource-limited environments ensures that the recommendations are culturally and economically feasible, fostering sustainable improvements in reproductive health outcomes. This work contributes to the global discourse on health equity by highlighting the disparities in birth outcomes that persist due to geographical and economic barriers.
The study aims to quantify the association between maternal sociodemographic factors, clinical comorbidities, and the incidence of stillbirth in LMIC settings to identify high-risk pregnancy profiles.
An observational case-control study was conducted across three tertiary maternity centers in sub-Saharan Africa and Southeast Asia between 2021 and 2023. The study population comprised 980 participants (320 stillbirth cases and 660 live-birth controls). Data were collected through structured clinical interviews, review of electronic medical records, and standardized physical examinations. Eligibility criteria included singleton pregnancies with a gestational age ≥28 weeks. Multivariate logistic regression analysis was employed to calculate Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (CI), controlling for variables such as maternal age, parity, and household income. Nutritional status was assessed using Mid-Upper Arm Circumference (MUAC) and hemoglobin levels. Statistical significance was defined as p
35 years (aOR 1.78) and history of prior stillbirth (aOR 2.88; 95% CI 1.45–5.72) were identified as independent risk factors. Socio-economically, mothers from the lowest income quintile faced a 1.9 times higher risk of fetal loss compared to those in the highest quintile. Intrapartum-related complications, specifically obstructed labor, accounted for 24% of the observed stillbirths in the case group.
The study confirms that stillbirth in LMICs is predominantly linked to suboptimal prenatal infrastructure and maternal health status rather than purely genetic factors. The high Odds Ratio associated with inadequate ANC suggests that increasing the frequency and quality of prenatal visits could reduce stillbirth rates by approximately 35-40% in the studied regions. Furthermore, addressing maternal anemia and malaria through proactive screening is essential. Policies must prioritize the decentralization of emergency obstetric care (EmONC) to mitigate the risks associated with prolonged labor and obstructed delivery. These findings advocate for a shift toward integrated community-based maternal health programs that emphasize early risk detection and rapid referral mechanisms. Reducing the global burden of stillbirth requires a concerted effort to improve socio-economic conditions alongside clinical interventions, ensuring equitable healthcare access for the most marginalized reproductive populations.