J F Frøen1, M Arnestad, K Frey, A Vege , O D Saugstad, B Stray-Pedersen. 1. Department of Obstetrics and Gynecology, the Institute of Forensic Medicine, and the Section for Clinical Epidemiology, The National Hospital, University of Oslo, Norway.
Abstract
OBJECTIVE: The epidemiologic characteristics of unexplained stillbirths are largely unknown or unreliable. We define sudden intrauterine unexplained death as a death that occurs antepartum and results in a stillbirth for which there is no explanation despite postmortem examinations, and we present risk factors for this type of stillbirth in singleton gestations. STUDY DESIGN: Singleton antepartum stillbirths (n = 291) and live births (n = 582) in Oslo were included and compared with national data (n = 2025 and n = 575,572, respectively). Explained stillbirths (n = 165) and live births in Oslo served as controls for the cases of sudden intrauterine unexplained death (n = 76) in multiple logistic regression analyses. RESULTS: One fourth of stillbirths remain unexplained. The risk of sudden intrauterine unexplained death (1/1000) increased with gestational age, high maternal age, high cigarette use, low education, and overweight or obesity. Primiparity and previous stillbirths or spontaneous abortions were not associated with sudden intrauterine unexplained death. CONCLUSIONS: Risk factors for sudden intrauterine unexplained death are identifiable by basic antenatal care. Adding unexplored stillbirths to the unexplained ones conceals several risk factors and underlines the necessity of a definition that includes thorough postmortem examinations.
OBJECTIVE: The epidemiologic characteristics of unexplained stillbirths are largely unknown or unreliable. We define sudden intrauterine unexplained death as a death that occurs antepartum and results in a stillbirth for which there is no explanation despite postmortem examinations, and we present risk factors for this type of stillbirth in singleton gestations. STUDY DESIGN: Singleton antepartum stillbirths (n = 291) and live births (n = 582) in Oslo were included and compared with national data (n = 2025 and n = 575,572, respectively). Explained stillbirths (n = 165) and live births in Oslo served as controls for the cases of sudden intrauterine unexplained death (n = 76) in multiple logistic regression analyses. RESULTS: One fourth of stillbirths remain unexplained. The risk of sudden intrauterine unexplained death (1/1000) increased with gestational age, high maternal age, high cigarette use, low education, and overweight or obesity. Primiparity and previous stillbirths or spontaneous abortions were not associated with sudden intrauterine unexplained death. CONCLUSIONS: Risk factors for sudden intrauterine unexplained death are identifiable by basic antenatal care. Adding unexplored stillbirths to the unexplained ones conceals several risk factors and underlines the necessity of a definition that includes thorough postmortem examinations.
Authors: J F Frøen; M Arnestad; A Vege; L M Irgens; T O Rognum; O D Saugstad; B Stray-Pedersen Journal: Arch Dis Child Fetal Neonatal Ed Date: 2002-09 Impact factor: 5.747
Authors: Halit Pinar; Matthew A Koch; Hal Hawkins; Josefine Heim-Hall; Carlos R Abramowsky; Vanessa R Thorsten; Marshall W Carpenter; Hong Holly Zhou; Uma M Reddy Journal: Am J Perinatol Date: 2011-08-03 Impact factor: 1.862
Authors: J Frederik Frøen; Halit Pinar; Vicki Flenady; Safiah Bahrin; Adrian Charles; Lawrence Chauke; Katie Day; Charles W Duke; Fabio Facchinetti; Ruth C Fretts; Glenn Gardener; Kristen Gilshenan; Sanne J Gordijn; Adrienne Gordon; Grace Guyon; Catherine Harrison; Rachel Koshy; Robert C Pattinson; Karin Petersson; Laurie Russell; Eli Saastad; Gordon C S Smith; Rozbeh Torabi Journal: BMC Pregnancy Childbirth Date: 2009-06-10 Impact factor: 3.007
Authors: J Frederik Frøen; Sanne J Gordijn; Hany Abdel-Aleem; Per Bergsjø; Ana Betran; Charles W Duke; Vincent Fauveau; Vicki Flenady; Sven Gudmund Hinderaker; G Justus Hofmeyr; Abdul Hakeem Jokhio; Joy Lawn; Pisake Lumbiganon; Mario Merialdi; Robert Pattinson; Anuraj Shankar Journal: BMC Pregnancy Childbirth Date: 2009-12-17 Impact factor: 3.007
Authors: Eli Saastad; Julie Victoria Holm Tveit; Vicki Flenady; Babill Stray-Pedersen; Ruth C Fretts; Per E Børdahl; J Frederik Frøen Journal: BMC Res Notes Date: 2010-01-04