# Stillbirths in a large Shanghai maternity centre (2014–2024): trends, sex distribution, and gestational age-specific risk

## TL;DR

This study analyzed stillbirth trends in a Shanghai maternity center from 2014 to 2024, finding no significant increase or sex disparities, with the highest risk at 28–31 weeks.

## Contribution

The study provides detailed insights into stillbirth trends, sex distribution, and gestational age-specific risk in a large Chinese cohort.

## Key findings

- Stillbirth rate remained consistently low (0.18%) with no significant increase from 2015 to 2023.
- Stillbirths were more common at 28–31 weeks and decreased with advancing gestational age.
- No significant sex disparities were observed in stillbirth rates.

## Abstract

Stillbirth is a catastrophic adverse pregnancy outcome that harms families and is a major global public health concern; however, the available data regarding its prevalence, sex disparities, and gestational age distribution (key for targeted interventions) are insufficient. This study addressed this gap in a large Shanghai pregnant cohort.

This retrospective study included 140,594 pregnant women (after incomplete/nonsingleton cases were excluded) who delivered at a tertiary hospital (Oct 2014–Sep 2024). Stillbirth was defined per the WHO guidelines (≥ 28 weeks). Stillbirth rates were calculated overall and stratified by foetal sex/gestational age (28–31, 32–36, and ≥ 37weeks). Mann‒Kendall test was used to assess trends (2015–2023), chi-square tests were used to compare subgroups, and analyses were performed in R 4.5.1 (P < 0.05 indicates statistical significance).

Among 140,594 deliveries, 249 stillbirths occurred (rate: 0.18%; 95% CI: 0.16–0.20%). The increasing trend from 2015–2023 was nonsignificant (Z = 0.738, P = 0.461; tau = 0.229), with no sex disparities (males: 51.81%; 129/249; females: 48.19%; 120/249; χ²=0.325; P = 0.5684). Regardless of sex, stillbirths were more common at 28–31 weeks and fewer at ≥ 37 weeks (male: χ²=28.79; female: χ²=21.05; P < 0.001).

Stillbirth rate in our maternity centre has remained consistently low over the past decade, with no significant temporal increase or sex-based disparities observed. The risk of stillbirth decreased with advancing gestational age, with the highest risk noted at 28–31 weeks; these findings underscore the need for targeted monitoring and interventions during the early phase of late pregnancy. Future multicentre studies are warranted to validate these findings and provide evidence to inform stillbirth prevention strategies.

The online version contains supplementary material available at 10.1186/s12884-026-08723-z.