• Acta Obstet Gynecol Scand · Mar 2013

    Classification of stillbirths and risk factors by cause of death--a case-control study.

    • Linda Björk Helgadóttir, Gitta Turowski, Finn Egil Skjeldestad, Anne Flem Jacobsen, Per Morten Sandset, Borghild Roald, and Eva-Marie Jacobsen.
    • Department of Hematology, Oslo University Hospital Ullevål, Oslo. linda_bjork_helgadottir@hotmail.com
    • Acta Obstet Gynecol Scand. 2013 Mar 1; 92 (3): 325-33.

    ObjectiveTo investigate risk factors for stillbirths by cause, using the Causes of Death and Associated Conditions (CODAC) classification system for perinatal deaths.DesignCase-control study.SettingTwo university hospitals in Oslo, Norway, January 1990 through December 2003.SampleWomen with stillbirth after 22 gestational weeks (n = 377) and controls with live births (n = 1 215), and a subsample of 105 cases and 262 controls.MethodsSocio-demographic, clinical and thrombophilic risk factors for stillbirths were assessed by cause of death in univariate and multivariable logistic regression analyses. Stillbirths were classified according to CODAC based on information from medical records and validated placenta histology.Main Outcome MeasuresCauses of stillbirths in percentages, prevalence, odds ratios and adjusted odds ratios for potential risk factors.ResultsApproximately half of the women (n = 190) had placental and 19.4% (n = 73) unknown cause of stillbirth. Placental-associated conditions were registered in 18% (n = 68) of cases with a non-placental or an unknown cause. Smoking and small-for-gestational age were more prevalent in all causal groups, compared with controls, whereas twin pregnancy, hypertension and diabetes were more prevalent only among women with placental and unknown causes of stillbirth. The F2rs179963 polymorphism and combined thrombophilia were significant risk factors for stillbirth with placental causes and antiphospholipid antibodies for stillbirth with non-placental causes.ConclusionsTwo-thirds of all stillbirths (68%) were caused by or associated with placental pathology. Risk factors differed somewhat according to cause, apart from smoking and small-for-gestational age, which were significant risk factors across the causal groups.© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

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