A multicenter, case–control study on risk factors for antepartum stillbirth

Abstract

Objective. As the influence of socio-demographic variables, lifestyle and medical conditions on the epidemiology of stillbirth (SB) is modified by population features, we aimed at investigating the role played by these factors on the incidence of SB in a developed country.

Study design. Multivariate logistic regression analysis (OR with 95% CI) was utilized in a prospective multicentre nested case–control study to compare in a 1:2 ratio stillborn of >22 weeks gestation with matched for gestational age live-born (LB) infants. Intrapartum SB were excluded.

Results. Two hundred fifty-four consecutive SBs and 497 LBs were enrolled. Socio-demographic variables were equally distributed. Fetal malformations (7.96, 2.69–23.55), severe intrauterine growth restriction (IUGR) (birthweight ≤5^th %ile) (4.32, 2.27–8.24), BMI > 25 (2.87, 1.90–4.33), and preeclampsia (PE, 0.40, 0.21–0.77) were recognized as independent predictors for SB. At term, only BMI > 25 was associated with SB (7.70, 2.9–20.5).

Conclusion. Fetal malformations, severe IUGR and maternal BMI > 25 were associated with a significant increase in the risk of SB; PE presented instead a protective role. Maternal BMI > 25 was the only risk factor for SB identified in term pregnancies.

Keywords:

• Stillbirth
• risk factors
• preeclampsia
• IUGR
• obesity

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.