Obesity and Diabetes as Main Risk Factors for Stillbirth in a Population from Northeastern Mexico

Abstract

Purpose Stillbirth is an important health problem in obstetrics practice. In Mexico, half of the stillbirths have an explainable cause. The aim of this study was to detect potential stillbirth risk factors and etiology by implementing a multidisciplinary workup at the Hospital Universitario “Dr. José Eleuterio González”. Methods This is a prospective, descriptive, observational study that included stillbirths from the Obstetrics Service from October 1st, 2019 to May 25, 2020. Evaluation strategies included a complete maternal medical history, physical examination of the fetus, and a photographic medical record. A stillbirth needed to have either a prenatal ultrasound, or a postnatal x-ray, and if possible, a fetal autopsy. Multiplex Ligation Probe Amplification (MLPA) was performed with an umbilical cord sample. Results Thirty-three stillbirths were reported; 21 were included in the analysis. Eleven mothers (52.3%) had known risk factors for stillbirth, mainly elevated body mass index and diabetes. On physical examination, external birth defects were found in 8 fetuses (38%). X-ray was performed in 14 cases (66%). Alterations were detected as a probable etiologic cause just in one. All cases underwent MLPA, which were reported negative. Three cases had criteria for autopsy. Findings were inconclusive to determine etiology. Conclusion Diabetes and obesity were the most frequent risk factors associated with stillbirth in this Mexican population. These factors are preventable by implementing strategies that lead to better prenatal care.