Causes of stillbirth in a socioeconomically disadvantaged urban Australian population - a comprehensive analysis
Date
2017
Authors
Wijs, L.
de Graaff, E.
Leemaqz, S.
Dekker, G.
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Journal article
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Journal of Maternal-Fetal and Neonatal Medicine, 2017; 30(23):2851-2857
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Laura Anna Wijs, Esti Charlotte de Graaff, Shalem Leemaqz and Gustaaf
Dekker
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Abstract
Introduction: The aim of this paper was to provide an in-depth analysis of all stillbirth causation over a period of 10 years in a busy maternity unit located in a socioeconomically disadvantaged urban area, with an emphasis on overlapping pathology. Materials and methods: A retrospective analysis of all structurally normal stillbirths in singleton pregnancies born during 2002–2012. The PSANZ stillbirth classification was used; per stillbirth subgroup main risk factors were evaluated. Results: Out of 130 cases, 43% showed overlapping pathologies. In the remaining 74 (56%) cases, the following single pathologies were found: IUGR 20 (15%), infection 12 (9%), abruption 8 (6%), placental thrombotic pathology 8 (6%), miscellaneous 6 stillbirths (5%), and 20 cases (15%) unexplained. Smoking was a risk factor for stillbirth associated with abruption (OR 3.639), infection (OR 2.271), and thrombotic pathology (OR 2.168). Drug use had an association with (placental) infection (OR 3.598). Obesity showed a significant association with IUGR (OR 3.782) and abruption (OR 9.040). Thrombophilia risk analysis for the overall group of stillbirths showed significant results for Protein S (OR 8.889) and homocysteine >90th centile (OR 2.087). Conclusions: Overlapping pathology was identified in 43% of stillbirths. Infection, IUGR, and abruption were the most important single cause of stillbirth.
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