• Manisha Kumar, Manju Puri, Reena Yadav, Ratna Biswas, Meenakshi Singh, Vidhi Chaudhary, Nishtha Jaiswal, and Deepika Meena.
• Department of Obstetrics and Gynecology, Lady Hardinge Medical College (LHMC, New Delhi, India.
• Int J Gynaecol Obstet. 2021 Apr 1; 153 (1): 76-82.

ObjectiveTo study the impact of the COVID-19 outbreak and subsequent lockdown on the incidence, associated causes, and modifiable factors of stillbirth.MethodsAn analytical case-control study was performed comparing stillbirths from March to September 2020 (cases) and March to September 2019 (controls) in a tertiary care center in India. Modifiable factors were observed as level-I, level-II, and level-III delays.ResultsA significant difference in the rate of stillbirths was found among cases (37.4/1000) and controls (29.9/1000) (P = 0.045). Abruption in normotensive women was significantly higher in cases compared to controls (P = 0.03). Modifiable factors or preventable causes were noted in 76.1% of cases and 59.6% of controls; the difference was highly significant (P < 0.001, relative risk [RR] 1.8). Level-II delays or delays in reaching the hospital for delivery due to lack of transport were observed in 12.7% of cases compared to none in controls (P < 0.006, RR 47.7). Level-III delays or delays in providing care at the facility were observed in 31.3% of cases and 11.5% of controls (P < 0.001, RR 2.7).ConclusionAlthough there was no difference in causes of stillbirth between cases and controls, level-II and level-III delays were significantly impacted by the pandemic, leading to a higher rate of preventable stillbirths in pregnant women not infected with COVID-19.© 2020 International Federation of Gynecology and Obstetrics.

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