Risk factors for antepartum death in term pregnancies

Abstract

Objective

To identify risk factors for antepartum fetal death (APD) in term pregnancies while considering maternal, pregnancy and fetal characteristics.

Materials and methods

Our study took place between the years 1988–2013. A total of 272,527 singleton births at term were recorded during this time period, including 524 cases of APD (0.2%). Cases of known chromosomal or other fetal abnormalities and cases with poor prenatal care were excluded. In order to identify independent risk factors contributing to antepartum fetal death in term we conducted a multivariate analysis using logistic regression.

Results

The main risk factors found to be significantly associated with APD in term were suspected intrauterine growth restriction (OR = 2.70, p < .001), diabetes (OR = 1.37, p = .05), hypertensive disorders (OR = 1.59, p = .01), advanced maternal age (OR = 1.03, p < .001) and grand-multiparity (OR = 1.79, p < .001). Advanced gestational age was not significantly associated with APD (38.95 vs. 39.44, p < .001).

Conclusions

Most of the risk factors for antepartum fetal death in term pregnancies found in this study coincide with known risk factors for APD as described in previous studies. We believe that in the presence of these risk factors, closer surveillance and careful medical management of the pregnancy are required, in order to reduce the incidence of APD, including induction of labor at advanced gestational age.

Keywords:

• Antepartum death
• stillbirth
• fetal death
• term birth
• intrapartum death

Acknowledgments

This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev.

Disclosure statement

No potential conflict of interest was reported by the author(s).