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Potentially Preventable Stillbirth in a Diverse U.S. Cohort
Jessica M Page1, Vanessa Thorsten, Uma M Reddy
1University of Utah School of Medicine, Salt Lake City, Utah; RTI International, Research Triangle Park, North Carolina; Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; the University of Virginia. Charlottesville, Virginia; Rollins School of Public Health, Emory University, Atlanta, Georgia; the University of Texas Medical Branch at Galveston, Galveston, Texas; Brown University School of Medicine, Providence, Rhode Island; the University of Texas Health Science Center at San Antonio, San Antonio, Texas; McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas; the University of Texas Health Science Center at Austin, Austin, Texas; and Columbia University, New York, New York.
Nearly one-fourth of stillbirths are potentially preventable. Addressing placental insufficiency, a leading cause, may significantly reduce stillbirth rates.
Area of Science:
- Perinatal Medicine
- Obstetrics
- Public Health
Background:
- Stillbirth remains a significant concern in perinatal medicine.
- Estimating the proportion of preventable stillbirths is crucial for targeted interventions.
Purpose of the Study:
- To estimate the proportion of potentially preventable stillbirths in the United States.
- Identify key contributing factors to preventable stillbirths.
Main Methods:
- Secondary analysis of 512 stillbirths from the Stillbirth Collaborative Research Network (2006-2008).
- Utilized a population-based case-control study with comprehensive evaluations including medical records, postmortem examinations, and placental pathology.
- Applied the Initial Causes of Fetal Death algorithm to assign causes.
Main Results:
- Potentially preventable stillbirths accounted for 22.3% (114 out of 512) of the cohort.
- Placental insufficiency was the leading cause (12.7%), followed by medical complications of pregnancy (6.1%) and hypertensive disorders (3.9%).
- Many stillbirths (27 cases) had multiple contributing factors.
Conclusions:
- A significant proportion of stillbirths are potentially preventable.
- Focusing on the identification and management of placental insufficiency offers the most promising avenue for stillbirth reduction.
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