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Landmark study pinpoints underlying cause of stillbirths in India and Pakistan

The research could help reduce child mortality in south Asia and low and middle-income countries

RESEARCH TRIANGLE PARK, N.C. — Researchers at RTI International, a nonprofit research institute, have found that fetal asphyxia and maternal hypertension are leading causes of stillbirth in south Asia. The prospective cohort study (PURPOSe), published by Lancet Global Health, is a step toward curbing the global burden of stillbirths and reducing child mortality rates in the region.

“Although progress has been made toward reducing child mortality in south Asia overall, the region contributes to over a third of stillbirths globally — a disproportionally large number,” said Elizabeth McClure, Ph.D., a perinatal epidemiologist in the Center for Clinical Research Network Coordination at RTI. “PURPOSe was launched to improve the specific estimates of causes of stillbirths in India and Pakistan; however, our findings are critical for understanding stillbirths in other low-income and middle-income countries (LMICs) across the globe.”

Researchers studied 611 stillborn infants between September 2018 and February 2021 in hospitals in central India and Pakistan. Findings indicated that the leading maternal cause was hypertensive disease (36%). The leading placental causes were maternal and fetal vascular malperfusion (47%) and the primary fetal cause was intrauterine hypoxia (72%).

“Our study adds to the understanding of the causes of stillbirth in south Asia as a whole,” said McClure. “With the rapid advancement of low-cost, evidence-based technologies and with appropriate early identification of women at a higher risk, there is substantial opportunity to reduce stillbirths in south Asia.”

The PURPOSe study is one of the largest evaluations of stillbirths to date. The study was funded by the Bill and Melinda Gates Foundation.

Read the full study in Lancet Global Health