Trends and Risk Factors of Birth Defects and Stillbirths in a Tertiary Hospital in Northern China (2019–2025): A Retrospective Analysis

Background ： Birth defects and stillbirths are major contributors to perinatal mortality and long-term childhood morbidity. In China, maternal and child health services have improved in recent years, yet the burden of these outcomes still varies across regions. We described the patterns of birth defects and stillbirths in a tertiary maternal and child health hospital in Northern China and assessed time trends over the study period. Methods：We performed a retrospective analysis of hospital registry data from 2019 to 2025. All recorded cases of birth defects and stillbirths were extracted. Demographic and clinical information and recorded etiologic findings were summarized. We described annual changes, maternal age distributions, birth defect categories, and causes of stillbirth using descriptive statistics and linear trend analyses. Results ： We included 430 birth defect cases (five available years) and 1,418 stillbirth cases (six available years). Mean maternal age was 28.8 ± 5.0 years among birth defect cases and 29.7 ± 6.0 years among stillbirth cases (p = 0.012). Congenital heart defects were the most common birth defect (32.6%), followed by neural tube defects (18.7%) and cleft lip/palate (15.3%). For stillbirths, fetal malformations accounted for 38.2% of cases, followed by placental/cord complications (22.6%) and maternal hypertensive disorders (15.1%). The number of stillbirth cases increased from 177 in 2020 to 307 in 2024 (β = 32.5, p < 0.001) and decreased to 202 in 2025. Conclusion ： In this Northern Chinese hospital population, congenital heart defects were the leading type of birth defect, and fetal malformations were the most common attributed cause of stillbirth. The increase in stillbirth cases observed from 2020 to 2024 warrants further evaluation, including possible changes in referral patterns, ascertainment, and population risk profiles. Strengthening prenatal screening and improving management of maternal complications may help reduce adverse perinatal outcomes.