Can We Prevent Stillbirth?

Fouks, Yuval; Tschernichovsky, Roi; Greenberg, Ariel; Bak, Stella; Sinai, Noa Brzezinski; Shinar, Shiri

doi:10.1055/s-0039-1683960

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Fetal death is defined as the product of pregnancy that shows no sign of life after the expulsion or complete extraction from the maternal organism 4 . Avoidable deaths are sentinel events, unnecessary and preventable events due to the proper functioning of health services with access to effective medical technologies 5 .…”

Section: Introductionmentioning

confidence: 99%

Spatial patterns of avoidable fetal mortality and social deprivation

Canuto

Macêdo

Frias

et al. 2021

Rev. bras. epidemiol.

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Objective: To develop a social need index for stratification of municipalities and identification of priority areas for reducing fetal mortality. Methods: ecological study, carried out in the state of Pernambuco, between 2010 and 2017. The technique of factor analysis by main components was used for the elaboration of the social need index. In the spatial analysis, the local empirical Bayesian estimator was applied and Moran's spatial autocorrelation was verified. Results: The social deprivation index selected two factors that, together, explained 77.63% of the total variance. The preventable fetal mortality rate increased among strata of social need, with rates of 8.0 per thousand births (low deprivation), 8.1 per thousand (medium deprivation), 8.8 per thousand (high deprivation), and 10.7 per thousand (very high social deprivation). Some municipalities in the São Francisco and Sertão Mesoregions had both high fetal and preventable fetal mortality, in addition to a very high social deprivation rate. Conclusion: The spatial analysis identified areas with the highest risk for fetal mortality. The social deprivation index listed some determinants of fetal deaths in areas with worse living conditions. Priority areas for intervention in public policies to reduce fetal mortality and its determinants were detected.

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Section: Introductionmentioning

confidence: 99%

Spatial patterns of avoidable fetal mortality and social deprivation

Canuto

Macêdo

Frias

et al. 2021

Rev. bras. epidemiol.

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“…Stillbirth rates in low- and middle-income countries are high . In high-income countries, a notable proportion of stillbirths (20%-30%) may occur due to substandard care, thus being preventable . The risk factors for intrapartum stillbirth may differ between high- and low-income countries .…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 In high-income countries, a notable proportion of stillbirths (20%-30%) may occur due to substandard care, thus being preventable. 6 , 7 The risk factors for intrapartum stillbirth may differ between high- and low-income countries. 8 In high-income countries, constantly decreasing fertility rates and postponement of first birth have been observed, and individuals giving birth at a more advanced age has resulted in an increasing number of at-risk pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Trends in Term Intrapartum Stillbirth in Norway

Murzakanova,

Räisänen,

Jacobsen

et al. 2023

JAMA Netw Open

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ImportanceFetal death during labor at term is a complication that is rarely studied in high-income countries. There is a need for large population-based studies to examine the rate of term intrapartum stillbirth in high-income countries and the factors associated with its occurrence.ObjectiveTo evaluate trends in term intrapartum stillbirth over time and to investigate the association between the trends and term intrapartum stillbirth risk factors from 1999 to 2018 in Norway.Design, Setting, and ParticipantsThis cohort study used data from the Medical Birth Registry of Norway from 1999 to 2018 to examine rates of term intrapartum stillbirth and risk factors associated with this event. A population of 1 021 268 term singleton pregnancies without congenital anomalies or antepartum stillbirths was included in analyses, which were performed from September 2022 to February 2023.ExposureThe main exposure variable was time, which was divided into four 5-year periods: 1999 to 2003, 2004 to 2008, 2009 to 2013, and 2014 to 2018.Main Outcomes and MeasuresThe primary study outcome was term intrapartum stillbirth. Risk ratios were calculated, and multivariable logistic regression analyses were conducted to identify factors associated with secular trends of term intrapartum stillbirth.ResultsThe study population consisted of 1 021 268 term singleton births (maternal mean [SD] age, 29.72 [5.01] years; mean [SD] gestational age, 39.69 [1.27] weeks). During the study period, there were 95 term intrapartum stillbirths (0.09 per 1000 births). Maternal age, the proportion of individuals born in a country other than Norway, and the prevalence of gestational diabetes, labor induction, operative vaginal delivery, and previous cesarean delivery increased over the course of the study period. Conversely, the prevalence of infants large for gestational age, hypertensive disorder in pregnancy, and spontaneous vaginal delivery and the proportion of individuals who smoked decreased. The term intrapartum stillbirth rate decreased by 87% (95% CI, 68%-95%) from 0.15 per 1000 births in 1999 to 2008 to 0.02 per 1000 births in 2014 to 2018. Three in 4 term intrapartum stillbirths (70 of 95) occurred during intrapartum operative deliveries. The increased prevalence of older maternal age and obstetric risk factors were not associated with the variation in intrapartum stillbirth rates among the time periods. The prevalence of term intrapartum stillbirth was higher for individuals who gave birth in maternity units with fewer than 3000 annual births (adjusted odds ratio, 1.67; 95% CI, 1.07-2.61) than for those who gave birth in units with 3000 or more annual births.Conclusions and RelevanceFindings of this study suggest that, despite increases in maternal and obstetric risk factors, term intrapartum stillbirth rates substantially decreased during the study period. Reasons for this decrease may be due to improvements in intrapartum care.

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“…У цих же спостереженнях відзначається порушення кровотоку в спіральних артеріях. Крім того, підвищення судинного опору в термінальних гілках артерії пуповини виявляється у жінок з вираженими ознаками дистрофічних змін в плацентарній тканині [28][29][30].…”

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Postponed Pregnancy in Modern Obstetrics

Kozar,

Kalinovska

2023

CAOS

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Delayed pregnancy is one of the key problems of modern obstetrics that requires attention and study. The article examines the current state of research and approaches to the diagnosis and treatment of this phenomenon, provides an analysis of literature data on risk factors for late pregnancy, features of the course of pregnancy and childbirth, complications during childbirth, and assessment of the condition of newborns.In particular, many authors pay attention to the increase in cases of delayed pregnancy in modern society and its possible causes. Particular attention is paid to the risk factors that may contribute to this condition, such as the age of the mother, the presence of chronic diseases, genetic aspects and other factors that may determine the occurrence of this condition.An analysis of the methods of diagnosing late pregnancy, including modern technologies that allow timely detection of this condition and determination of its causes, was also carried out. In the literature, the authors note the role of ultrasound examination and its eﬀ ectiveness in detecting and studying late pregnancy. Current approaches to the management of late pregnancy, such as drug therapy, surgery, and supportive care, are highlighted.Most authors emphasize the importance of an individualized approach to each case of late pregnancy and the determination of optimal treatment that takes into account both medical and psychosocial aspects.It has been shown that late pregnancy signiﬁ cantly aﬀ ects the intrauterine condition of the fetus and the development of diseases in the early neonatal period, therefore the authors discuss possible ways to prevent such consequences, as well as the importance of postpartum care and monitoring.The article highlights the perspective of further research into this pathology and the importance of developing new technologies and approaches to improve the diagnosis and treatment of delayed pregnancy in the future. The role of biomarkers and genetic tests for early diagnosis and prediction of late pregnancy is highlighted. Overall, the article makes an important contribution to the understanding and management of late pregnancy in modern obstetrics.

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Can We Prevent Stillbirth?

Cited by 4 publications

References 22 publications

Spatial patterns of avoidable fetal mortality and social deprivation

Spatial patterns of avoidable fetal mortality and social deprivation

Trends in Term Intrapartum Stillbirth in Norway

Postponed Pregnancy in Modern Obstetrics

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