Stillbirth and fetal anomalies: secondary analysis of a case–control study

Objective Approximately 10% of stillbirths are attributed to fetal anomalies, but anomalies are also common in live births. We aimed to assess the relationship between anomalies, by system and stillbirth. Design Secondary analysis of a prospective, case–control study. Setting Multicentre, 59 hospita...

Full description

Saved in:
Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2021-01, Vol.128 (2), p.252-258
Main Authors: Son, SL, Allshouse, AA, Page, JM, Debbink, MP, Pinar, H, Reddy, U, Gibbins, KJ, Stoll, BJ, Parker, CB, Dudley, DJ, Varner, MW, Silver, RM, Conway, Deborah, Aufdemorte, Karen, Rodriguez, Angela, Pina, Monica, Nelson, Kristi, Rowland Hogue, Carol J, Tinsley, Janice Daniels, Shehata, Bahig, Abramowsky, Carlos, Coustan, Donald, Carpenter, Marshall, Kubaska, Susan, Saade, George R, Bukowski, Radek, Rollins, Jennifer Lee, Hawkins, Hal, Sbrana, Elena, Koch, Matthew A, Thorsten, Vanessa R, Franklin, Holly, Chen, Pinliang, Shriver, Eunice Kennedy, Willinger, Marian, Goldenberg, Robert L
Format: Article
Language:English
Subjects:
Adult
Anomaly
Birth defects
Case-Control Studies
Congenital Abnormalities - epidemiology
Congenital Abnormalities - pathology
congenital anomaly
Congenital diseases
Female
fetal anomaly
Fetal Diseases - epidemiology
Fetal Diseases - pathology
Fetuses
Genetic analysis
Gestational age
Humans
Incidence
Live Birth
Odds Ratio
Pregnancy
Prospective Studies
Risk Factors
Stillbirth
Stillbirth - epidemiology
Thorax
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective Approximately 10% of stillbirths are attributed to fetal anomalies, but anomalies are also common in live births. We aimed to assess the relationship between anomalies, by system and stillbirth. Design Secondary analysis of a prospective, case–control study. Setting Multicentre, 59 hospitals in five regional catchment areas in the USA. Population or sample All stillbirths and representative live birth controls. Methods Standardised postmortem examinations performed in stillbirths, medical record ion for stillbirths and live births. Main outcome measures Incidence of major anomalies, by type, compared between stillbirths and live births with univariable and multivariable analyses using weighted analysis to account for study design and differential consent. Results Of 465 singleton stillbirths included, 23.4% had one or more major anomalies compared with 4.3% of 1871 live births. Having an anomaly increased the odds of stillbirth; an increasing number of anomalies was more highly associated with stillbirth. Regardless of organ system affected, the presence of an anomaly increased the odds of stillbirth. These relationships remained significant if stillbirths with known genetic abnormalities were excluded. After multivariable analyses, the adjusted odds ratio (aOR) of stillbirth for any anomaly was 4.33 (95% CI 2.80–6.70) and the systems most strongly associated with stillbirth were cystic hygroma (aOR 29.97, 95% CI 5.85–153.57), and thoracic (aOR16.18, 95% CI 4.30–60.94) and craniofacial (aOR 35.25, 95% CI 9.22–134.68) systems. Conclusions In pregnancies affected by anomalies, the odds of stillbirth are higher with increasing numbers of anomalies. Anomalies of nearly any organ system increased the odds of stillbirth even when adjusting for gestational age and maternal race. Tweetable Stillbirth risk increases with anomalies of nearly any organ system and with number of anomalies seen. Tweetable Stillbirth risk increases with anomalies of nearly any organ system and with number of anomalies seen.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.16517