Incidence Rate and Probable Risk Factors of Macerated and Fresh Stillbirths at Maternity Teaching Hospital Erbil

Background and Objectives: Stillbirth is the death of a baby after 28 weeks of pregnancy but before or during birth is a major health problem worldwide. Almost 2 million babies are stillborn each year, mostly in poorer countries. Even though it’s common, Stillbirths aren't always reported, and public health programs don't focus on it enough. This study wants to figure out how many stillbirths happen at the Maternity Teaching Hospital in Erbil, Iraq, and what things might make them more likely. The study will look at both "macerated" (where the baby has been deceased for some time before birth) and "fresh" (death just before or during birth) stillbirths. Methods: A study from January 1, 2023, to January 1, 2024, included 390 pregnant women: 130 stillbirth cases and 260 controls. Data on sociodemographic, maternal health, antenatal care, and delivery were collected via questionnaires. SPSS version 28 was used for statistical analysis, with significance at ≤ 0.05. Results: The overall stillbirth incidence was 2%, with macerated stillbirths making up 85.4% of cases. Significant associations were observed between stillbirth and maternal occupation, residence, education, parity, smoking, prior stillbirth, pre-eclampsia, clotting disorders, and genital infections. Women residing in rural areas, those with lower education levels, and those with limited access to antenatal care experienced higher rates of stillbirth. The majority of stillbirths occurred in multiparous women, and congenital anomalies, including hydrops fetalis, were identified as a significant risk factor. Conclusion: The study identified a significant burden of stillbirths at the Maternity Teaching Hospital in Erbil, with most cases being macerated stillbirths. Key factors associated with increased risk included maternal occupation, low education levels, history of prior stillbirths, chronic conditions such as preeclampsia, and limited access to antenatal care.