Factors associated with stillbirth in São Paulo, Brazil: FetRiskS - a multidisciplinary case-control study
Stillbirth remains a significant public health issue, with socioeconomic, demographic, environmental, behavioral, healthcare, and biological factors influencing its occurrence. This study aimed to investigate the risk factors for stillbirths in São Paulo, Brazil. This population-based case-control study included stillbirths (cases) and live births (controls) from 14 public hospitals in the city of São Paulo, Brazil. Data were obtained from interviews with women after delivery, hospital records, antenatal care registries, placental samples, and maternal blood samples for analysis of infection biomarkers. A logistic regression model was used to estimate the odds ratio (OR) with a 95% confidence interval. The study included 401 stillbirths (348 antepartum and 53 intrapartum) and 419 live births. The final model identified significant risk factors for stillbirth, including the absence of a partner (OR = 1.76; 95%CI: 1.15–2.68), smoking during pregnancy (OR = 1.94; 95%CI: 1.10–3.47), inadequate antenatal care access (OR = 2.15; 95%CI: 1.38–3.39), hyperglycemia (OR = 1.91; 95%CI: 1.21–3.03), the presence of placental lesions (OR = 3.15; 95%CI: 2.20–4.52), fetal growth restriction (OR = 6.16; 95%CI: 3.76–10.4), and congenital malformations (OR = 4.25; 95%CI: 2.42–7.67). This study identifies critical maternal and fetal factors associated with stillbirth risk in a middle-income country, showing its complex profile.
Authors
- Márcia Furquim de Almeida (ORCID: https://orcid.org/0000-0003-0052-1888)
- Laura C. Rodrigues (ORCID: https://orcid.org/0000-0001-9008-660X)
- Osmara Alves dos Santos (ORCID: https://orcid.org/0000-0001-6360-861X)
- Lays Janaina Prazeres Marques (ORCID: https://orcid.org/0000-0003-4511-4995)
- Andrés Jimenez Galisteo (ORCID: https://orcid.org/0000-0003-1611-6721)
- Rodrigo Melim Zerbinati (ORCID: https://orcid.org/0000-0001-9936-9139)
- Rafael Junqueira Buralli (ORCID: https://orcid.org/0000-0001-7006-6177)
- Hillegonda Maria Dutilh Novaes (ORCID: https://orcid.org/0000-0001-9849-0324)
- Gabriella Ferreira Demarque (ORCID: https://orcid.org/0000-0001-7104-8931)
- Luciana Regina Meireles (ORCID: https://orcid.org/0000-0003-0913-1579)
- Mara Sandra Hoshida (ORCID: https://orcid.org/0000-0003-2232-4631)
- Luciana Duzolina Manfré Pastro (ORCID: https://orcid.org/0000-0001-5268-4713)
- Regina Schultz (ORCID: https://orcid.org/0000-0002-8736-8208)
- Darío Elías (ORCID: https://orcid.org/0000-0002-6576-8569)
- Nélson Gouveia (ORCID: https://orcid.org/0000-0003-0625-0265)
- Rossana Pulcineli Vieira Francisco (ORCID: https://orcid.org/0000-0002-9981-8069)
- Zilda Pereira da Silva (ORCID: https://orcid.org/0000-0003-4648-113X)
- Gizelton Pereira Alencar (ORCID: https://orcid.org/0000-0002-2354-9050)
- Clarisse Martins Machado (ORCID: https://orcid.org/0000-0003-1417-0249)
- Gerusa Maria Figueiredo (ORCID: https://orcid.org/0000-0001-9657-9675)
Institutions
- Universidade de São Paulo (BR)
- London School of Hygiene & Tropical Medicine (GB)
- Departamento de Epidemiología (GT)
- Instituto de Medicina Tropical (PY)
- Instituto de Saúde (BR)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
Publication Details
- Journal
- BMC Pregnancy and Childbirth
- Published
- 2025-12-02
- DOI
- https://doi.org/10.1186/s12884-025-08427-w
- Citations
- 1
- Primary Topic
- Maternal and Neonatal Healthcare
- Type
- article
- Field-Weighted Citation Impact
- 2.82