Risk Factors for Stillbirth ID'd at the Start of Pregnancy
And, racial disparity seen in stillbirth-related obstetric complications, placental abnormalities
TUESDAY, Dec. 13 (HealthDay News) -- Several risk factors that can be identified at the time of pregnancy confirmation correlate with stillbirth; and obstetric complications and placental abnormalities are the most common causes of stillbirth, and show racial discrepancies, according to two studies published in the Dec. 14 issue of the Journal of the American Medical Association.
Radek Bukowski, M.D., Ph.D., from the University of Texas Medical Branch in Galveston, and colleagues investigated the correlation between stillbirths and risk factors that could be identified at the start of pregnancy among 614 stillbirths and 1,816 controls. On multivariate analysis, the factors which independently correlated with stillbirths included non-Hispanic black race, previous stillbirth, nulliparity with and without previous losses at less than 20 weeks' gestation, diabetes, maternal age ≥40 years, maternal AB blood type, drug addiction history, smoking during the three months before pregnancy, obesity/overweight, not living with a partner, and plurality. Little of the variance in pregnancy outcome was explained by these factors (generalized R² = 0.12).
In another study, Bukowski and colleagues assessed the causes of stillbirth in a racially and geographically diverse population of 500 women with 512 stillbirths. A probable cause of death was identified in 60.9 percent of stillbirths, with common causes including obstetric conditions, placental abnormalities, fetal genetic/structural abnormalities, infection, umbilical cord abnormalities, hypertensive disorders, and other maternal medical conditions. Non-Hispanic black women had a significantly higher proportion of stillbirths correlating with obstetric complications and infections than non-Hispanic white and Hispanic women. Intrapartum and early gestational stillbirths were more common in non-Hispanic black women.
"Obstetric conditions and placental abnormalities were the most common causes of stillbirth, although the distribution differed by race/ethnicity" Bukowski and colleagues write in the second study.