Perinatal mortality and its associated factors in selected tertiary care hospital of Belagavi, Karnataka, India

Abstract Background: In many low- and middle-income countries, stillbirths are generally defined as those occurring after 28 weeks of gestation, whereas in some high-income countries, the threshold is set at 20 completed weeks of gestation. The stillbirth rate is acknowledged as a sensitive indicator of healthcare quality and equity. All provinces have demonstrated accelerated progress in reducing stillbirths. Materials and Methods: This study aimed to identify the risk factors associated with perinatal mortality among 3508 mothers who delivered at selected tertiary care hospitals in Belagavi, Karnataka, India. Using consecutive sampling, mothers from labor rooms and maternity wards were surveyed via the Maternal and Newborn Health Registry. Results: The perinatal mortality rate observed in this study was 36.48/1000 live births. Among the mothers, 78.9% were anemic, 11.86% experienced antepartum hemorrhage (APH), and 79.7% had hypertensive disorders during pregnancy. Additionally, 13.8% of neonates suffered from birth asphyxia, 6.1% presented with hypothermia, and 21.1% of births were preterm, with gestational ages ranging from 28 weeks and 6 days to 36 weeks and 6 days. Conclusion: The study conducted at tertiary care facilities revealed that most stillbirths were preventable and primarily linked to conditions such as APH, maternal hypertension, labor hypoxia, and low birth weight. Many of these deaths could be avoided through skilled obstetric care, which includes prenatal and intrapartum screening for specific conditions, fetal heart rate monitoring during labor, and timely interventions, often involving cesarean delivery. There is an urgent need for a global classification system and perinatal mortality audits to understand the causes better and enhance prevention efforts.