More than six out of every thousand deliveries in India in 2020 may have ended in stillbirth, with urban mothers recording higher rates than their rural counterparts, a recent analysis has revealed.
Researchers from the All India Institute of Medical Sciences, Gorakhpur, and the Indian Council of Medical Research, New Delhi, examined data from the fifth National Family Health Survey (NFHS-5) and the 2020 Civil Registration System (CRS), maintained by the Ministry of Home Affairs. Their findings, published in The Lancet Regional Health, Southeast Asia, reveal that stillbirth hotspots are concentrated in northern and central India.
Chandigarh, Jammu and Kashmir, and Rajasthan recorded the highest stillbirth rates in the north. The nationwide stillbirth rate (SBR) in 2020 stood at 6.548 per 1,000 total births, with rates for females at 6.54 and for males at 6.63.
The analysis found a correlation between higher stillbirth rates and districts with a higher prevalence of anaemia and underweight among pregnant women, conditions known to heighten the risk of adverse birth outcomes.
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“Hygienic menstrual practices and caesarean (C-section) deliveries were associated with a lower rate of stillbirth, especially in Telangana, Karnataka, and Tamil Nadu,” the authors noted. NFHS-5 data shows that in 2019–2020, the prevalence of C-section deliveries in southern India was around 45 per cent.
Evidence from states such as Assam, Meghalaya, Maharashtra, Uttar Pradesh, Himachal Pradesh, and Chhattisgarh indicated that at least four antenatal check-ups and adherence to iron and folic acid supplementation could significantly reduce the risk.
Overall, higher stillbirth rates were observed in areas where pregnant women were anaemic, deliveries took place predominantly in public health facilities, and wealth indices were lower.
While there was no statistically significant disparity in stillbirth rates by sex across districts, the marginally higher rate among male foetuses suggests a possible biological vulnerability, the researchers observed.
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