Abstract 3: Determinants of Stillbirth and Adverse Live Birth Outcomes in High Risk Pregnancies: Evidence from a Retrospective Observational Study

Abstract Background: High-risk pregnancies are marked by maternal or fetal conditions that significantly increase the likelihood of adverse outcomes. Among these, stillbirth represents one of the most devastating complications, while live birth under such high-risk conditions remains a key indicator of successful perinatal care. This study aims to evaluate and compare the clinical profiles of stillbirths and live births in high-risk pregnancies, with the goal of identifying contributing factors and preventive strategies. Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynecology over a period of JAN 2024-JUNE 2024. A total of 76 high-risk pregnancies were included, divided into two arms: 38 cases resulting in stillbirth and 38 in live birth. High-risk status was defined based on the presence of conditions such as hypertensive disorders, diabetes, severe anemia, intrauterine growth restriction (IUGR), placental abnormalities, short icp and maternal age. Data were collected from hospital records and analyzed to identify patterns and associations. Results: This retrospective observational study compared 38 stillbirths and 38 live births in high-risk pregnancies. The mean maternal age was comparable between groups (29.7 vs. 28.8 years). Stillbirths were significantly associated with unbooked status (76.3% unbooked), lower mean birth weight (2106 g vs. 2615 g), and higher prevalence of comorbidities such as hypertensive disorders, gestational diabetes, intrahepatic cholestasis of pregnancy (IHCP), antepartum hemorrhage (APH), and anemia. Hypertensive disorders and GDM were the most common risk factors overall, while IHCP and APH were more strongly linked with stillbirth. These findings highlight the importance of early antenatal booking and timely management of maternal comorbidities to improve perinatal outcomes. Conclusion: This study highlights that stillbirths in high-risk pregnancies are often linked to preventable or manageable conditions. Emphasis on early identification, structured antenatal care, and prompt multidisciplinary intervention can significantly reduce perinatal mortality and improve live birth outcomes in high-risk obstetric populations.