EC Gynaecology

Objectives: The purpose of this study was to identify risk factors for stillbirth in patients at our teaching hospital in two cohorts more than a decade apart.

Study Design: Retrospective review of all stillbirths from January 2006 to December 2007 compared to March 2019 to March 2021. Institutional review board approval was obtained. Factors evaluated included maternal demographics, health care access, insurance coverage, obstetric history, maternal, fetal, and placental evaluation. Multivariate logistic regression analysis was performed in the 2019 - 2021 cohort.

Results: There were 156 stillbirths and 10,207 concurrent live births (15.3 per 1000 livebirths) during 2006 to 2007. Similarly, there were 76 stillbirths and 5,235 concurrent livebirths (14.5 per 1000 livebirths) in 2019 to 2021. Data from the 2006-2007 group suggested that young, Black women were at greater risk of presenting with a stillbirth when compared with hispanic or white women (p < 0.01). In the 2019 - 2021 group, patients presenting with a stillbirth were significantly older (p < 0.01) and had more pregnancies (p < 0.01) at time of presentation. Despite increased prenatal care (p < 0.01) and more access to health insurance (p < 0.05) reported in the 2019-2021 group the stillbirth rate was not significantly different.

Conclusion: Despite improvements in access to prenatal care and increased levels of health insurance coverage over a 13-year interval, the frequency of presenting with a stillbirth at our teaching institution remains high compared to the national average. Efforts should be made towards improving the quality of prenatal care and eliminating sociodemographic disparities.

Implication Statement: Despite improvements in access to prenatal care and increased levels of health insurance coverage over a 13-year interval, the frequency of presenting with a stillbirth at our teaching institution remains high compared to the national average. Future studies that address the social contextual and structural determinants of health (e.g. income, housing, food security, neighborhood environment) that would support the ability to assess the predictors of change in racial inequities in stillbirth over time are needed.

 Keywords: Stillbirth; Intrauterine Fetal Demise; Fetal Death; Socioeconomic Disparity

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