Community-based stillbirth rates and risk factors in rural Sarlahi, Nepal

Int J Gynaecol Obstet. 2011 Jun;113(3):199-204. doi: 10.1016/j.ijgo.2010.12.015. Epub 2011 Apr 1.


Objective: To assess stillbirth rates and antepartum risk factors in rural Nepal.

Methods: Data were collected prospectively during a cluster-randomized, community-based trial in Sarlahi, Nepal, from 2002 to 2006. Multivariate regression modeling was performed to calculate adjusted relative risk estimates.

Results: Among 24531 births, the stillbirth rate was 35.4 per 1000 births (term stillbirth rate 21.2 per 1000 births). Most births occurred at home without a skilled birth attendant. The majority (69%) of intrapartum maternal deaths resulted in stillbirth. The adjusted RR (aRR) of stillbirth was 2.74 among nulliparas and 1.47 among mothers with history of a child death. Mothers above the age of 30 years carried a 1.59-fold higher risk for stillbirth than mothers who were 20-24 years old. The stillbirth risk was lower among households where the father had any formal education (aRR 0.70). Land ownership (aRR 0.85) and Pahadi ethnicity (aRR 0.67; reference: Madhesi ethnicity) were associated with significantly lower risks of stillbirth.

Conclusion: Stillbirth rates were high in rural Nepal, with the majority of stillbirths occurring at full-term gestation. Nulliparity, history of prior child loss, maternal age above 30 years, Madhesi ethnicity, and socioeconomic disadvantage were significant risk factors for stillbirth. Clinicaltrials.govNCT00 109616.

Trial registration: NCT00109616.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Logistic Models
  • Maternal Age
  • Nepal / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Rural Health
  • Socioeconomic Factors
  • Stillbirth / epidemiology*
  • Young Adult

Associated data