Predictive Model for Late Stillbirth Among Antenatal Hypertensive Women.

Abstract

To develop a predictive model for late stillbirth among women with hypertensive disorders of pregnancy (HDP) in low- and middle-income countries. Study was part of the WHO newborn birth defect (NBBD) project and included all stillbirths occurring in the facility from November 2015 to December 2020. The age and parity matched subjects with HDP having live birth were taken as controls. All significant predictors were analyzed and a predictive model was developed. Out of 69,007 deliveries, 1691(24.5/1000) were stillborn. HDP was seen in (390/1691, 23.0%), in 265/390 (67.4%) cases it occurred at or after 28weeks of gestation and were included as cases. On comparing the cases with controls, the significant factors were estimated fetal weight less than 2000 gms (P < 0.001, OR 10.3), poor antenatal care (p < 0.001, OR-5.9), family history of hypertension (p < 0.018, OR-4.4) and the presence of gestational hypertension (p = 0.001, OR 2.2). The predictive model had sensitivity and specificity of 80.3% and 70.03%, respectively, the receiver operating curve showed the area under the curve(AUC) in the range of good prediction (0.846). The predictive model could play a potential role in stillbirth prevention in women with HDP in low- and middle-income countries. The online version contains supplementary material available at 10.1007/s13224-021-01561-3.