Trends, Pattern and Correlates of Perinatal Mortality in India (2005–2021)

Abstract Background: Perinatal mortality (PM) is linked to maternal and neonatal healthcare and the socioeconomic and bio-demographic attributes of the mother and family. Aim: This study assesses the trends and risk factors of PM in India from 2005 to 2021. Materials and Methods: Analysing the data from three rounds of National Family Health Surveys (NFHS), the study examined socio-demographic and biological predictors of Perinatal for children who died within 7 days of birth after 28 weeks of gestation. Results: India’s Perinatal rate (PNMR) declined by 33.3%, from 48 per 1000 live births in NFHS-3–32 per 1000 in NFHS-5. States such as Goa, Andhra Pradesh and Rajasthan showed reductions exceeding 50%, while Uttarakhand, Sikkim and Meghalaya experienced increase in PMR. The key risk factors for PM included advancing maternal age (>28 years, odds ratio [OR] = 2.27), higher birth order (≥3, OR = 1.45) and short birth intervals (<2 years). Protective factors included higher maternal and paternal education, wealthier socioeconomic status and birth intervals of 2–3 years. Conclusion: India has witnessed a gradual decline in PNMR over the two decades; however, disparities persist across socio-economic groups and states, with slower declines in empowered action group and north-eastern states. Strengthening maternal and neonatal healthcare, improving the quality of antenatal and intrapartum care and focused efforts to enhance access to quality healthcare services, particularly among vulnerable populations, are essential to achieve the Sustainable Development Goal targets of single-digit PMR by the year 2030.