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J Perinatol. 2010 May;30(5):311-8. doi: 10.1038/jp.2009.158. Epub 2009 Oct 15.

The risk factors for unexplained antepartum stillbirths in Scotland, 1994 to 2003.

Author information

1
Department of Community Health, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia. rosnah@medic.ukm.my

Abstract

OBJECTIVE:

To determine the factors contributing to unexplained antepartum stillbirth in Scotland.

STUDY DESIGN:

A 10-year birth database in Scotland was used to compare the unexplained antepartum stillbirth with other birth outcomes. The sample unit was a pregnant mother with a gestational age of 20 weeks and above and with a fetal birth weight of 200 g and above.

RESULT:

Maternal age of 35 years and above, lower deprivation category, inaccessible area of residence, maternal smoking, maternal height of <160 cm and gestational age of above 39 weeks were significantly associated with unexplained antepartum stillbirth. In multivariable analysis only maternal age (adjusted odds ratio (OR): 1.8, confidence interval (CI): 1.1 to 3.0, P=0.02), smoking during pregnancy (adjusted OR: 2.0, CI: 1.1 to 3.5, P=0.02), and maternal height (adjusted OR: 1.4, CI: 1.1 to 1.8, P=0.01), remain significant. Screening of pregnancies based on these three risk factors had 4.2% sensitivity and 99.4% specificity. The prevalence of stillbirth for this population was 0.2%. A positive predictive value of only 1.2% implies that only 1 in 83 women with these three risk factors will have antepartum stillbirth. The remaining 82 will suffer needless anxiety and potentially diagnostic procedures.

CONCLUSION:

Advanced maternal age, maternal smoking, and shorter maternal height were associated risk for unexplained antepartum stillbirth but screening based on these factors would be of limited value.

PMID:
19829298
PMCID:
PMC2864419
DOI:
10.1038/jp.2009.158
[Indexed for MEDLINE]
Free PMC Article
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