Objective - To investigate behavioural and social characteristics of women who experienced a late stillbirth compared to women with ongoing live pregnancies at similar gestation. Design - Case-control study. Setting – 41 maternity units in the United Kingdom. Population - Women who had a stillbirth ≥28 weeks’ gestation (n=287) and women with an ongoing pregnancy at the time of interview (n=714). Methods - Data were collected using an interviewer-administered questionnaire which included questions regarding women’s behaviours (e.g. alcohol intake and household smoke exposure) and social characteristics (e.g. ethnicity, employment, housing). Stress was measured by the 10-item Perceived Stress Scale. Main outcome measure – Late stillbirth. Results - Multivariable analysis adjusting for co-existing social and behavioural factors showed women living in the most deprived quintile had increased risk of stillbirth compared to the least deprived quintile (adjusted Odds Ratio (aOR) 3.16; 95% CI 1.47, 6.77). There was an increased risk of late stillbirth associated with unemployment (aOR 2.32; 95% CI 1.00, 5.38) and women who declined to answer the question about domestic abuse (aOR 4.12; 2.49, 6.81). A greater number of antenatal visits than recommended was associated with a reduction in stillbirth (aOR 0.26; 0.16, 0.42). Conclusions - This study demonstrates associations between late stillbirth and socio-economic deprivation, perceived stress, domestic abuse highlighting the need for strategies to prevent stillbirth to extend beyond maternity care. Enhanced antenatal care may be able to mitigate some of the increased risk of stillbirth.
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Early online date||29 Sep 2020|
|Publication status||E-pub ahead of print - 29 Sep 2020|
Heazell, A. E. P., Budd, J., Smith, L., Li, M., Cronin, R., Bradford, B., McCowan, L., Mitchell, E., Stacey, T., Roberts, D., & Thompson, J. (2020). Associations Between Social and Behavioural Factors and the Risk of Late Stillbirth – Findings from the Midland and North of England Stillbirth Case-Control Study. BJOG: An International Journal of Obstetrics and Gynaecology. https://doi.org/10.1111/1471-0528.16543