Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study

Tomasina Stacey, John MD Thompson, Edwin A Mitchell, Jane M Zuccollo, Alec J Ekeroma, Lesley ME McCOWAN

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Introduction Stillbirth remains an important public health problem in Australia and New Zealand. The role that antenatal care plays in the prevention of stillbirth in high‐income countries is unclear. Methods Cases were women with a singleton, late stillbirth without congenital abnormality, booked to deliver in the Auckland region and born between July 2006 and June 2009. Two controls with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Data were collected through interview‐administered questionnaires and from antenatal records. Results One hundred and fifty five of 215 (72%) cases and 310 of 429 (72%) controls consented to take part in the study. Accessing <50% of recommended antenatal visits was associated with a more than twofold increase in late stillbirth (adjusted odds ratio, aOR, 2.68; 95% CI, 1.04–6.90) compared with accessing the recommended number of visits. Small‐for‐gestational‐age (SGA) babies that had not been identified as SGA prior to birth were significantly more at risk of being stillborn (aOR, 9.46; 95% CI, 1.98–45.13) compared with SGA babies that were identified as such in the antenatal period. No relationship was found between type or model of maternity care provider at booking and late stillbirth risk. Discussion This study reinforces the importance of regular antenatal care attendance. Identification of SGA may be one way by which antenatal care reduces stillbirth.
Original languageEnglish
Pages (from-to)242-247
Number of pages6
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume52
Issue number3
Early online date25 Jan 2012
DOIs
Publication statusPublished - 1 Jun 2012
Externally publishedYes

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Prenatal Care
Stillbirth
Fetal Development
Pregnancy
New Zealand
Public Health
Odds Ratio
Parturition

Cite this

Stacey, Tomasina ; Thompson, John MD ; Mitchell, Edwin A ; Zuccollo, Jane M ; Ekeroma, Alec J ; McCOWAN, Lesley ME. / Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study. In: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2012 ; Vol. 52, No. 3. pp. 242-247.
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Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study. / Stacey, Tomasina; Thompson, John MD; Mitchell, Edwin A; Zuccollo, Jane M; Ekeroma, Alec J; McCOWAN, Lesley ME.

In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 52, No. 3, 01.06.2012, p. 242-247.

Research output: Contribution to journalArticle

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AU - Thompson, John MD

AU - Mitchell, Edwin A

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AU - Ekeroma, Alec J

AU - McCOWAN, Lesley ME

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N2 - Introduction Stillbirth remains an important public health problem in Australia and New Zealand. The role that antenatal care plays in the prevention of stillbirth in high‐income countries is unclear. Methods Cases were women with a singleton, late stillbirth without congenital abnormality, booked to deliver in the Auckland region and born between July 2006 and June 2009. Two controls with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Data were collected through interview‐administered questionnaires and from antenatal records. Results One hundred and fifty five of 215 (72%) cases and 310 of 429 (72%) controls consented to take part in the study. Accessing <50% of recommended antenatal visits was associated with a more than twofold increase in late stillbirth (adjusted odds ratio, aOR, 2.68; 95% CI, 1.04–6.90) compared with accessing the recommended number of visits. Small‐for‐gestational‐age (SGA) babies that had not been identified as SGA prior to birth were significantly more at risk of being stillborn (aOR, 9.46; 95% CI, 1.98–45.13) compared with SGA babies that were identified as such in the antenatal period. No relationship was found between type or model of maternity care provider at booking and late stillbirth risk. Discussion This study reinforces the importance of regular antenatal care attendance. Identification of SGA may be one way by which antenatal care reduces stillbirth.

AB - Introduction Stillbirth remains an important public health problem in Australia and New Zealand. The role that antenatal care plays in the prevention of stillbirth in high‐income countries is unclear. Methods Cases were women with a singleton, late stillbirth without congenital abnormality, booked to deliver in the Auckland region and born between July 2006 and June 2009. Two controls with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Data were collected through interview‐administered questionnaires and from antenatal records. Results One hundred and fifty five of 215 (72%) cases and 310 of 429 (72%) controls consented to take part in the study. Accessing <50% of recommended antenatal visits was associated with a more than twofold increase in late stillbirth (adjusted odds ratio, aOR, 2.68; 95% CI, 1.04–6.90) compared with accessing the recommended number of visits. Small‐for‐gestational‐age (SGA) babies that had not been identified as SGA prior to birth were significantly more at risk of being stillborn (aOR, 9.46; 95% CI, 1.98–45.13) compared with SGA babies that were identified as such in the antenatal period. No relationship was found between type or model of maternity care provider at booking and late stillbirth risk. Discussion This study reinforces the importance of regular antenatal care attendance. Identification of SGA may be one way by which antenatal care reduces stillbirth.

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KW - risk factors

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