Risk factors for sudden intrauterine unexplained death: Epidemiologic characteristics of singleton cases in Oslo, Norway, 1986-1995

Objective: The epidemiologic characteristics of unexplained stillbirths are largely unknown or unreliable. We define sudden intrauterine unexplained death as a death that occurs antepartum and results in a stillbirth for which there is no explanation despite postmortem examinations, and we present r...

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Published in:American journal of obstetrics and gynecology 2001-03, Vol.184 (4), p.694-702
Main Authors: Frøen, J.Frederik, Arnestad, Marianne, Frey, Kathrine, Vege, Åshild, Saugstad, Ola Didrik, Stray-Pedersen, Babill
Format: Article
Language:English
Subjects:
Abortion, Spontaneous
Adult
antepartum
Biological and medical sciences
Diseases of mother, fetus and pregnancy
Educational Status
epidemiology
Female
Fetal Death - epidemiology
Fetal Death - etiology
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Maternal Age
Medical sciences
Norway - epidemiology
obesity
Obesity - complications
Odds Ratio
Parity
Pregnancy
Pregnancy, High-Risk
Pregnancy. Fetus. Placenta
Prenatal Care
Registries
Risk Factors
smoking
Smoking - adverse effects
Unexplained stillbirth
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Summary:Objective: The epidemiologic characteristics of unexplained stillbirths are largely unknown or unreliable. We define sudden intrauterine unexplained death as a death that occurs antepartum and results in a stillbirth for which there is no explanation despite postmortem examinations, and we present risk factors for this type of stillbirth in singleton gestations. Study Design: Singleton antepartum stillbirths (n = 291) and live births (n = 582) in Oslo were included and compared with national data (n = 2025 and n = 575,572, respectively). Explained stillbirths (n = 165) and live births in Oslo served as controls for the cases of sudden intrauterine unexplained death (n = 76) in multiple logistic regression analyses. Results: One fourth of stillbirths remain unexplained. The risk of sudden intrauterine unexplained death (1/1000) increased with gestational age, high maternal age, high cigarette use, low education, and overweight or obesity. Primiparity and previous stillbirths or spontaneous abortions were not associated with sudden intrauterine unexplained death. Conclusions: Risk factors for sudden intrauterine unexplained death are identifiable by basic antenatal care. Adding unexplored stillbirths to the unexplained ones conceals several risk factors and underlines the necessity of a definition that includes thorough postmortem examinations. (Am J Obstet Gynecol 2001;184:694-702.)
ISSN:0002-9378
1097-6868
DOI:10.1067/mob.2001.110697