Intrauterine deaths - an unsolved problem in Polish perinatology

Area of Science:

• Perinatal Medicine
• Obstetrics
• Public Health

Background:

• The Polish criteria define intrauterine death for fetuses after 22 weeks gestation, weighing over 500g, or measuring at least 25cm.
• Poland registered 1,231 stillbirths in 2020, with a rate of 3:10,000 in 2015.
• Stillbirth risk is elevated in women experiencing preterm delivery.

Purpose of the Study:

• To analyze stillbirth rates and contributing factors in Poland between 2015-2020.
• To identify demographic and gestational risk factors associated with stillbirth.
• To investigate the causes of fetal death in relation to gestational age.

Main Methods:

• Analysis of 142,662 births in Poland from 2015-2020.
• Subgroup analysis of pregnancies: before 30 weeks (n=229) and from 30 weeks onwards (n=179).
• Inclusion of women at risk of preterm delivery.

Main Results:

• Stillbirth occurred in 41% of first pregnancies.
• Average stillbirth weight was 1487g, with an average length of 40cm.
• Maternal age extremes (<15 and >45 years) showed the highest rates of fetal death. Male fetuses were more common up to 30 weeks, while females predominated after 30 weeks.

Conclusions:

• Fetal growth restriction (FGR) and placental-umbilical issues are significant causes of stillbirth, particularly in fetuses over 30 weeks gestation.
• Hypoxia and acute intrapartum events contribute to stillbirth, especially in cases of FGR.
• Stillbirth is a significant concern in first pregnancies and at advanced maternal ages.