Temporal trends and sex disparities in live and stillbirths: A five-year study at ring road general hospital, Ibadan, Nigeria

Background: Stillbirth remains a critical indicator of maternal and perinatal health, with global disparities influenced by time, season, and fetal sex. Understanding localized patterns is essential to evaluate the impact of health interventions. This five-year retrospective study examined temporal trends and sex-related disparities in live births and stillbirths at Ring Road General Hospital, Ibadan, Nigeria (2020–2024), in the context of targeted maternal care improvements. Objective: To assess temporal and seasonal trends in birth outcomes and evaluate sex-based disparities in stillbirth risk over a five-year period. Method: A retrospective analysis of 4,294 birth records (live and stillbirths) was conducted from January 2020 to December 2024. Time-series analysis was used to identify seasonal and annual trends. Kruskal-Wallis and chi-square goodness-of-fit tests assessed differences in outcomes across time and sex. Logistic regression was employed to examine the association between fetal sex and stillbirth risk. Results: Live births showed significant seasonal variation, with peaks in the first and second quarters of each year. Stillbirth rates declined substantially from 21.38 to 2.99 per 1,000 births over the study period (p < 0.05), suggesting improved outcomes. The sex ratio remained stable for both live births (1.07 male-to-female) and stillbirths (1.00), with no significant deviation from expected norms. Male fetuses had 22.6% higher odds of stillbirth compared to females, though this difference was not statistically significant (OR = 1.226, p = 0.159). Conclusion: This study revealed a marked reduction in stillbirth rates over five years, likely reflecting the success of maternal health interventions and enhanced data surveillance. The consistent sex ratios and lack of significant sex-based disparity in stillbirth risk diverge from global patterns, indicating equitable maternal and neonatal care practices within the study setting.