Trends in Term Intrapartum Stillbirth in Norway.

Area of Science:

• Obstetrics and Gynecology
• Perinatal Epidemiology
• Public Health

Background:

• Term intrapartum stillbirth is a rare but critical complication, particularly understudied in high-income nations.
• There is a need for population-based research to understand the incidence and associated factors of term intrapartum stillbirth.

Purpose of the Study:

• To analyze trends in term intrapartum stillbirth rates in Norway between 1999 and 2018.
• To investigate the relationship between these trends and identified risk factors for term intrapartum stillbirth.

Main Methods:

• A population-based cohort study utilized data from the Medical Birth Registry of Norway (1999-2018).
• Included 1,021,268 term singleton pregnancies without congenital anomalies or antepartum stillbirths.
• Analyzed secular trends using multivariable logistic regression, dividing the study period into four 5-year intervals.

Main Results:

• The term intrapartum stillbirth rate decreased by 87%, from 0.15 to 0.02 per 1000 births between 1999-2008 and 2014-2018.
• Despite increased maternal age and obstetric risk factors, the stillbirth rate declined significantly.
• Higher stillbirth rates were observed in maternity units with fewer than 3000 annual births (aOR, 1.67).

Conclusions:

• Term intrapartum stillbirth rates substantially decreased in Norway over two decades, contrary to increasing maternal and obstetric risk factors.
• Improvements in intrapartum care are suggested as the primary driver for this significant reduction in fetal death during labor.
• Findings highlight the importance of intrapartum care quality, especially in smaller maternity units.