Interventions for investigating and identifying the causes of stillbirth

Abstract

There is currently a lack of RCT evidence regarding the effectiveness of interventions for investigating and identifying the causes of stillbirth. Seeking to determine the causes of stillbirth is an essential component of quality maternity care, but it remains unclear what impact these interventions have on the psychosocial outcomes of parents and families, the rates of diagnosis of the causes of stillbirth, and the care and management of subsequent pregnancies following stillbirth. Due to the absence of trials, this review is unable to inform clinical practice regarding the investigation of stillbirths, and the specific investigations that would determine the causes.Future RCTs addressing this research question would be beneficial, but the settings in which the trials take place, and their design, need to be given careful consideration. Trials need to be conducted with the utmost care and consideration for the needs, concerns, and values of parents and families. Assessment of longer-term psychosocial variables, economic costs to health services, and effects on subsequent pregnancy care and outcomes should also be considered in any future trials.

Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis

“…As less than 1% of the pregnant women included in this analysis were enrolled and treated in the first trimester, the risk of congenital abnormality due to antimalarial drugs is expected to be very low in the current study. Congenital abnormalities in stillborns were presumably underreported, but autopsy or chromosomal investigation was not mentioned in any of the study sites [63,64]. Due to the availability of information, placental pigmentation was analysed only qualitatively, while a previous study revealed AL reduced the level of pigmentation more than quinine [53].…”

Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

“…Multiple logistic regression was performed for variables with p < 0.1 in the univariate analysis. We also included variables that were risk indicators reported in previous studies (age, parity and ethnicity [ 7 , 12 , 17 , 18 ]). The results of the multiple logistic regression were reported as adjusted odds ratio (aOR).…”

“…Stillbirths should be systematically assessed to identify risk factors and causes and provide strategies for reducing the SBR [ 6 ]. Obtaining reliable statistics is challenging since stillbirths are often poorly documented by the vital registry [ 4 – 7 ]. A literature review [ 8 ] revealed that, between 2009 and 2014, more than 81 systems were in place to classify causes of perinatal deaths, complicating cross-country comparison [ 8 ].…”

Risk Factors of Stillbirth Among Women Who Gave Birth in Amhara Region Referral Hospitals, Ethiopia, in 2019: A Case-Control Study

“…8 Decreasing the global burden of stillbirth mainly focuses on strategic interventions and to enable these strategic interventions to minimize stillbirth rate, identification of risk factors of stillbirth is needed. 9 The risk factors of a large proportion of stillbirths remain unknown despite an improvement in antenatal and intrapartum care and extensive testing. 10,11 Previous studies have identified that several factors were linked with the occurrence of stillbirth.…”