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A case-control study of intrapartum stillbirths
L M Alessandri1, F J Stanley, A W Read
1Western Australian Research Institute for Child Health, Perth.
British Journal of Obstetrics and Gynaecology
|September 1, 1992
Summary
Intrapartum stillbirths are primarily linked to labor and delivery complications, not antenatal factors. Earlier intervention during labor, especially in emergency cesarean sections, may prevent some stillbirths.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Public Health
Background:
- Intrapartum stillbirth remains a significant concern in perinatal medicine.
- Identifying preventable risk factors is crucial for improving fetal outcomes.
Purpose of the Study:
- To investigate antenatal and intrapartum risk factors associated with intrapartum stillbirths in a total population.
- To inform strategies for stillbirth prevention.
Main Methods:
- A matched case-control study was conducted in Western Australia between 1980 and 1983.
- Cases were intrapartum stillbirths (>= 1000g birthweight), matched with liveborn controls for various factors.
Main Results:
- Placental abruption, fetal distress, cord prolapse, and unhealthy placentas were significant risk factors for intrapartum stillbirth.
- Vaginal breech delivery and emergency cesarean section were also associated with increased stillbirth risk.
- Lack of labor and normal delivery were protective factors, with longer labors in emergency cesarean cases.
Conclusions:
- Antenatal factors showed little predictive value for intrapartum stillbirths.
- Labor and delivery complications were the primary identified risk factors.
- Earlier intervention during labor, particularly for emergency cesarean sections, could potentially prevent some intrapartum stillbirths.