The Auckland Stillbirth study, a case--control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale

Tomasina Stacey, John Md Thompson, Edwin A Mitchell, Alec J Ekeroma, Jane M Zuccollo, Lesley Me Mccowan

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.
LanguageEnglish
Pages3-8
Number of pages6
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume51
Issue number1
DOIs
Publication statusPublished - 8 Feb 2011
Externally publishedYes

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Stillbirth
Third Pregnancy Trimester
Case-Control Studies
Pregnancy
Maternal Behavior
Fetal Death
Health Behavior
Fetal Development
Parity
New Zealand
Gestational Age
Interviews

Cite this

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title = "The Auckland Stillbirth study, a case--control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale",
abstract = "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.",
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The Auckland Stillbirth study, a case--control study exploring modifiable risk factors for third trimester stillbirth : methods and rationale. / Stacey, Tomasina; Thompson, John Md; Mitchell, Edwin A; Ekeroma, Alec J; Zuccollo, Jane M; Mccowan, Lesley Me.

In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 51, No. 1, 08.02.2011, p. 3-8.

Research output: Contribution to journalArticle

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