Prevalence and Risk Factors of Intrauterine Fetal Death: Insights from a Referral Maternity Center
| Author | Mansoureh Zargar | en |
| Author | Maryam Razavi | en |
| Author | Firoozeh Rakhshani Moghaddam | en |
| Author | Aghdas Abdolrazaghnejad | en |
| Orcid | Maryam Razavi [0000-0001-9983-9743] | en |
| Orcid | Firoozeh Rakhshani Moghaddam [0009-0002-3116-7594] | en |
| Orcid | Aghdas Abdolrazaghnejad [0000-0003-2020-7837] | en |
| Issued Date | 2026-02-28 | en |
| Abstract | Background: Intrauterine fetal death (IUFD) is a significant obstetric complication with profound medical, psychological, and social consequences. Despite advances in prenatal care, IUFD remains a pressing concern, particularly in developing regions where healthcare disparities persist. Understanding the prevalence and associated risk factors is crucial for developing preventive strategies and improving maternal-fetal outcomes. Objectives: The present study aimed to determine the prevalence of IUFD and examine its associated maternal, fetal, and obstetric factors among pregnant women admitted to the Maternity Ward of Ali Ibn Abi Talib Hospital in Zahedan, Iran, from 2015 to 2018. Methods: A cross-sectional study was conducted by reviewing 23,220 delivery records over a three-year period. Cases of IUFD were identified based on the clinical definition of fetal demise occurring after 20 weeks of gestation or with a fetal weight of at least 500 grams (500 g). A total of 500 IUFD cases were included in the final analysis. Data on maternal demographics, medical history, prenatal care, fetal complications, and placental abnormalities were collected and analyzed using IBM SPSS Statistics Version 22.0. Results: The overall prevalence of IUFD was 2.2% (500 cases out of 23,220 deliveries). The IUFD was significantly more frequent in vaginal deliveries compared to cesarean sections (P < 0.001). The majority of cases occurred in women aged 20 - 34 years (71.6%), with lower education levels associated with higher IUFD incidence (P < 0.001). Gestational age was a critical factor, with most IUFDs occurring between 27 - 34 weeks (38.0%) (P = 0.001). A history of stillbirth (P < 0.001), inadequate prenatal care (P < 0.001), and maternal comorbidities such as hypertension (28.6%) and diabetes (19.0%) were significantly associated with IUFD. Notably, umbilical cord abnormalities were present in 99.0% of cases, making them the leading contributory factor. Conclusions: The IUFD remains a significant concern, with maternal health conditions, prenatal care quality, and umbilical cord complications playing pivotal roles. Strengthening prenatal surveillance, early identification of high-risk pregnancies, and addressing modifiable maternal risk factors could substantially reduce IUFD rates. This study was limited by its retrospective design and reliance on hospital records, which may have led to incomplete documentation of key variables such as the timing and precise causes of IUFD. Inconsistent recording of pathological findings further restricted detailed etiologic analysis. Future prospective studies with standardized data collection and comprehensive pathological evaluation are recommended to better elucidate IUFD risk factors and mechanisms. | en |
| DOI | https://doi.org/10.5812/semj-161681 | en |
| Keyword | Pregnancy Complications | en |
| Keyword | Pregnancy Outcome | en |
| Keyword | Prenatal Care | en |
| Keyword | Maternal Age | en |
| Publisher | Brieflands | en |
| Title | Prevalence and Risk Factors of Intrauterine Fetal Death: Insights from a Referral Maternity Center | en |
| Type | Research Article | en |
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