BACKGROUND: In high-income countries, stillbirth rates have been static in recent decades. Unexplained stillbirths account for up to 50% of these deaths. METHODS: A case-control study was conducted in Auckland, New Zealand, from July 2006 to June 2009 to explore modifiable risk factors for late stillbirth (≥28 weeks of gestation). Eligible participants were women who had a singleton late stillbirth without a congenital abnormality. Two controls with ongoing pregnancies were randomly selected at the same gestation as each case. Data were collected through face-to-face interviews and from clinical records. RESULTS: A total of 155/215 (72%) cases and 310/429 (72%) controls consented to take part in the study. Women who had a late stillbirth were more likely to be of Pacific ethnicity and of parity ≥4 (OR = 1.7, 95% CI: 1.1-2.6 and 2.7, 95% CI: 1.4-5.3, respectively). The median gestational age at diagnosis of fetal death was 261 days (IQR 239-279), and the median gestation at which the controls were interviewed was 264.5 days (IQR 240-274) P = 0.48. 'Unexplained antepartum death' (n = 61, 39.4%) and 'fetal growth restriction' (n = 29, 18.7%) accounted for almost 60% of stillbirths. The post-mortem rate for all cases was 47% (73/155) and 43% (26/61) for those classified as 'unexplained antepartum death'. CONCLUSION: This study of risk factors for stillbirth is novel in that it used gestation-matched controls with ongoing pregnancies. Its detailed investigation into maternal health and behaviour during pregnancy has the potential to lead to a better understanding of modifiable risk factors for late stillbirth.
BACKGROUND: In high-income countries, stillbirth rates have been static in recent decades. Unexplained stillbirths account for up to 50% of these deaths. METHODS: A case-control study was conducted in Auckland, New Zealand, from July 2006 to June 2009 to explore modifiable risk factors for late stillbirth (≥28 weeks of gestation). Eligible participants were women who had a singleton late stillbirth without a congenital abnormality. Two controls with ongoing pregnancies were randomly selected at the same gestation as each case. Data were collected through face-to-face interviews and from clinical records. RESULTS: A total of 155/215 (72%) cases and 310/429 (72%) controls consented to take part in the study. Women who had a late stillbirth were more likely to be of Pacific ethnicity and of parity ≥4 (OR = 1.7, 95% CI: 1.1-2.6 and 2.7, 95% CI: 1.4-5.3, respectively). The median gestational age at diagnosis of fetal death was 261 days (IQR 239-279), and the median gestation at which the controls were interviewed was 264.5 days (IQR 240-274) P = 0.48. 'Unexplained antepartum death' (n = 61, 39.4%) and 'fetal growth restriction' (n = 29, 18.7%) accounted for almost 60% of stillbirths. The post-mortem rate for all cases was 47% (73/155) and 43% (26/61) for those classified as 'unexplained antepartum death'. CONCLUSION: This study of risk factors for stillbirth is novel in that it used gestation-matched controls with ongoing pregnancies. Its detailed investigation into maternal health and behaviour during pregnancy has the potential to lead to a better understanding of modifiable risk factors for late stillbirth.
Authors: Tomasina Stacey; John M D Thompson; Edwin A Mitchell; Alec J Ekeroma; Jane M Zuccollo; Lesley M E McCowan Journal: BMC Pregnancy Childbirth Date: 2011-01-12 Impact factor: 3.007
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Authors: Alexander E P Heazell; Christopher J Weir; Sarah J E Stock; Catherine J Calderwood; Sarah Cunningham Burley; J Frederik Froen; Michael Geary; Alyson Hunter; Fionnuala M McAuliffe; Edile Murdoch; Aryelly Rodriguez; Mary Ross-Davie; Janet Scott; Sonia Whyte; Jane E Norman Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
Authors: Arthur Chortatos; Per Ole Iversen; Margaretha Haugen; Malin Eberhard-Gran; Elisabeth Krefting Bjelland; Marit B Veierød Journal: BMC Pregnancy Childbirth Date: 2018-05-08 Impact factor: 3.007
Authors: Jayne Platts; Edwin A Mitchell; Tomasina Stacey; Bill L Martin; Devender Roberts; Lesley McCowan; Alexander E P Heazell Journal: BMC Pregnancy Childbirth Date: 2014-05-21 Impact factor: 3.007
Authors: Jordan P R McIntyre; Cayley M Ingham; B Lynne Hutchinson; John M D Thompson; Lesley M McCowan; Peter R Stone; Andrew G Veale; Robin Cronin; Alistair W Stewart; Kevin M Ellyett; Edwin A Mitchell Journal: BMC Pregnancy Childbirth Date: 2016-05-18 Impact factor: 3.007