Publications

Cohort profile of the ICMR-Stillbirth Pooled India Cohort (ICMR-SPIC): estimating prevalence, analysing risk factors and developing prediction models for stillbirths in India.

PURPOSE: Stillbirth is a significant public health problem in India, yet comprehensive epidemiological data on its prevalence and risk factors are  lacking. The objectives of this research were to develop a dataset pooled from 10  well-characterised pregnancy cohorts across urban and rural India to estimate the  prevalence of stillbirths, identify and quantify risk factors and develop a  predictive risk stratification model for evidence-based clinical decision-making  in high-risk pregnancies. PARTICIPANTS: Pregnant women were enrolled during the  antenatal period in 10 existing cohorts across India. Enrolment occurred through  either health facilities or community settings at four urban, four rural and two  mixed urban-rural sites spanning nine states. All participants were enrolled  before childbirth, with follow-up completed at least until delivery. FINDINGS TO  DATE: The Indian Council of Medical Research (ICMR) stillbirth pooled India  cohort (ICMR-Stillbirth Pooled India Cohort Dataset (SPIC)) comprises 229 695  pregnant women. The mean (SD) maternal age at recruitment was 24.8 (4.5) years.  22.2% were underweight (body mass index (BMI)<18.5 kg/m²) and 16.6% were  overweight or obese (BMI≥23 kg/m²). Short stature (<145 cm) was observed in 6.9%  of participants. The mean (SD) gestational age at birth was 38.4 (2.1) weeks.  One-third of the participants (33.3%) experienced moderate-to-severe anaemia  during pregnancy (haemoglobin<95 g/L), 52.8% were multiparous and 27.6% conceived  within 18 months of their previous childbirth. Core maternal risk factors such as  short stature, BMI, parity, prior stillbirths and anaemia during pregnancy were  recorded in all cohorts. Additional variables, including gestational weight gain,  pre-eclampsia/eclampsia, antepartum haemorrhage and fetal distress, were  available for over 80% of the cohorts, ensuring robust data coverage for risk  factor analysis and modelling. FUTURE PLANS: ICMR-SPIC will be used to conduct  individual-level pooled data analyses to estimate prevalence, identify key risk  factors and develop predictive models for stillbirths. Findings will inform  policies, clinical guidelines and targeted interventions for high-risk  pregnancies. The harmonised ICMR-SPIC dataset is a landmark collaborative effort  to advance maternal and newborn health in India.