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Kasahara M, Koshida S, Tokoro S, Katsura D, Tsuji S, Murakami T, Takahashi K. Potential prevention of stillbirth caused by placental abruption: a regional population-based study in Japan. J Matern Fetal Neonatal Med 2024; 37:2321485. [PMID: 38403932 DOI: 10.1080/14767058.2024.2321485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Placental abruption is associated with adverse perinatal outcomes including intrauterine fetal demise, which subsequently results in stillbirth. However, few studies have demonstrated the preventability of stillbirth due to placental abruption. Therefore, we evaluated the possibility of preventing stillbirth caused by placental abruption by reviewing all stillbirths in our region. METHODS This study reviewed all stillbirths after 22 weeks of gestation in Shiga Prefecture, Japan from 2010 to 2019, excluding lethal disorders. We evaluated 350 stillbirth cases, with and without placental abruption. RESULTS There were 32 stillbirths with PA and 318 without placental abruption. The probability of preventing stillbirth was significantly higher in patients with placental abruption than in those without (30% vs. 8%, p < 0.001). We also determined the recommendations for preventing stillbirths with placental abruption. CONCLUSION Some stillbirths caused by placental abruption can be prevented. We recommend improvements to perinatal maternal-fetal care and perinatal emergency transport systems.
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Affiliation(s)
- Makiko Kasahara
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Shigeki Koshida
- Perinatal Center, Shiga University of Medical Science, Otsu-city, Japan
| | - Shinsuke Tokoro
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Daisuke Katsura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu-city, Japan
| | - Kentaro Takahashi
- Perinatal Center, Shiga University of Medical Science, Otsu-city, Japan
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Yang HY, Lee JKW, Chio CP. Extreme temperature increases the risk of stillbirth in the third trimester of pregnancy. Sci Rep 2022; 12:18474. [PMID: 36323816 PMCID: PMC9630541 DOI: 10.1038/s41598-022-23155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies have reported the association between extreme temperatures and adverse reproductive effects. However, the susceptible period of exposure during pregnancy remains unclear. This study aimed to assess the impact of extreme temperature on the stillbirth rate. We performed a time-series analysis to explore the associations between temperature and stillbirth with a distributed lag nonlinear model. A total of 22,769 stillbirths in Taiwan between 2009 and 2018 were enrolled. The mean stillbirth rate was 11.3 ± 1.4 per 1000 births. The relative risk of stillbirth due to exposure to extreme heat temperature (> 29 °C) was 1.18 (95% CI 1.11, 1.25). Pregnant women in the third trimester were most susceptible to the effects of extreme cold and heat temperatures. At lag of 0-3 months, the cumulative relative risk (CRR) of stillbirth for exposure to extreme heat temperature (29.8 °C, 97.5th percentile of temperature) relative to the optimal temperature (21 °C) was 2.49 (95% CI: 1.24, 5.03), and the CRR of stillbirth for exposure to extreme low temperature (16.5 °C, 1st percentile) was 1.29 (95% CI: 0.93, 1.80). The stillbirth rate in Taiwan is on the rise. Our findings inform public health interventions to manage the health impacts of climate change.
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Affiliation(s)
- Hsiao-Yu Yang
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,grid.19188.390000 0004 0546 0241Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jason Kai Wei Lee
- grid.4280.e0000 0001 2180 6431Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Global Asia Institute, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431N.1 Institute for Health, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Institute for Digital Medicine, National University of Singapore, Singapore, Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Chia-Pin Chio
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,Department of Medical Research, Tung’ Taichung Metro Harbor Hospital, Taichung, Taiwan
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Wright RG, Macindoe C, Green P. Placental Abnormalities Associated With Childbirth. Acad Forensic Pathol 2019; 9:2-14. [PMID: 34394786 DOI: 10.1177/1925362119851113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/24/2018] [Indexed: 11/17/2022]
Abstract
Pathologists are faced with a variety of problems when considering placental tissue in cases of stillbirth. It is recognized that there are changes which occur following fetal demise and which can complicate the assessment and may coexist with other morphological changes. It is recognized that up to 25% of stillbirths may have a recognizable abnormality causing fetal demise. A systematic review of placental tissue allows many of these disorders to be identified. This review considers macroscopic and microscopic features of placental pathology in stillbirth together with clinicopathological correlation. Stillbirth definitions, general aspects of macroscopic assessment of placentas, placental changes after fetal demise, and some recognizable causes of fetal demise are considered.
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Agena AG, Modiba LM. Maternal and foetal medical conditions during pregnancy as determinants of intrapartum stillbirth in public health facilities of Addis Ababa: a case-control study. Pan Afr Med J 2019; 33:21. [PMID: 31312337 PMCID: PMC6615772 DOI: 10.11604/pamj.2019.33.21.17728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/09/2019] [Indexed: 01/08/2023] Open
Abstract
Introduction globally, intrapartum stillbirth accounts for 1 million deaths of babies annually, representing approximately one-third of global stillbirth toll. Intrapartum stillbirth occurs due to causes ranging from maternal medical and obstetric conditions; access to quality obstetric care services during pregnancy; and types, timing and quality of intrapartum care. Different medical conditions including hypertensive & metabolic disorders, infections and nutritional deficiencies during pregnancy are among risk factors of stillbirth. Ethiopia remains one of the 10 high-burden stillbirth countries with estimated rate of more than 25 per 1000 births. Methods a case-control study using primary data from chart review of medical records of women who experienced intrapartum stillbirth in 23 public health facilities of Addis Ababa during the period July 1, 2010 - June 30, 2015 was conducted. Data was collected from charts of all cases of intrapartum stillbirth meeting the inclusion criteria and randomly selected charts of controls in two to one (2:1) control to case ratio. Results chronic medical conditions including diabetes, cardiac and renal diseases were less prevalent (1%) among the study population whereas only 6% of women experienced hypertensive disorder during the pregnancy in review. Moreover, 6.5% of the study population had HIV infection where being HIV negative was protective against intrapartum stillbirth (aOR 0.37, 95% CI 0.18-0.78). Women with non-cephalic foetal presentation during last ANC visit were three times more at risk of experiencing intrapartum stillbirth whereas singleton pregnancy had strong protective association against intrapartum stillbirth (p<0.05). Conclusion untreated chronic medical conditions, infection, poor monitoring of foetal conditions and multiple pregnancy are among important risk factors for intrapartum stillbirth.
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Affiliation(s)
| | - Lebitsi Maud Modiba
- Department of Health Studies, University of South Africa, TvW 7-160 College of Human Sciences, Unisa, South Africa
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Trends and risk factors of stillbirth in Taiwan 2006–2013: a population-based study. Arch Gynecol Obstet 2019; 299:961-967. [DOI: 10.1007/s00404-019-05090-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/02/2019] [Indexed: 12/26/2022]
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Abir T, Agho KE, Ogbo FA, Stevens GJ, Page A, Hasnat MA, Dibley MJ, Raynes-Greenow C. Predictors of stillbirths in Bangladesh: evidence from the 2004-2014 nation-wide household surveys. Glob Health Action 2018; 10:1410048. [PMID: 29261451 PMCID: PMC5757223 DOI: 10.1080/16549716.2017.1410048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Globally, stillbirth remains a significant public health issue, particularly in developing countries such as Bangladesh. Objective: This study aimed to investigate the potential predictors of stillbirths in Bangladesh over a ten-year period. Methods: The Bangladesh Demographic and Health Surveys data for the years 2004, 2007, 2011 and 2014 (n = 29,094) were used for the study to investigate the predictors of stillbirths. Stillbirth was examined against a set of community, socio-economic and child characteristics, using a multivariable logistic regression model that adjusted for cluster and sampling variability. Results: The pooled rate of stillbirth in Bangladesh was 28 in 1000 births (95% CI: 22, 34). Stillbirth rates were higher in rural compared to urban areas in Bangladesh. Mothers who had a secondary or higher level of education (OR = 0.59, 95%CI: 0.43–0.82, P = 0.002) and those with primary education (OR = 0.66, 95%CI: 0.55–0.80, P < 0.001) were less likely to experience stillbirths compared to mothers with no education. Mothers with more than two children were significantly less likely to have stillbirths compared to mothers with one child. Those from poor households reported increased odds of stillbirth compared to those from rich households. Conclusion: Our analysis indicated that no maternal education, primiparity and poor household were predictors of stillbirths in Bangladesh. A collaborative effort is needed to reduce stillbirth rates among these high-risk groups in Bangladesh, with the socio-economic and health-related Sustainable Development Goals providing a critical vehicle for the co-ordination of this work.
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Affiliation(s)
- Tanvir Abir
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Penrith , Australia
| | - Kingsley E Agho
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Penrith , Australia
| | - Felix A Ogbo
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Penrith , Australia
| | - Garry J Stevens
- b Humanitarian and Development Research Initiative (HADRI), School of Social Science and Psychology , Western Sydney University , Penrith , Australia
| | - Andrew Page
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Penrith , Australia
| | - Milton A Hasnat
- c School of Medicine and Public Health, Faculty of Health and Medicine , The University of Newcastle , Callaghan , Australia
| | - Michael J Dibley
- d Sydney School of Public Health, Edward Ford Building (A27) , University of Sydney , Sydney , Australia
| | - Camille Raynes-Greenow
- d Sydney School of Public Health, Edward Ford Building (A27) , University of Sydney , Sydney , Australia
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Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol 2017; 34:935-957. [PMID: 28329897 PMCID: PMC5683164 DOI: 10.1055/s-0037-1599149] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption. Results A total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy. Conclusion Few studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.
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Affiliation(s)
- Katheryne L. Downes
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Obstetrics and Gynecology, Center for Research in Reproduction and Women’s Health, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katherine L. Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Edmond D. Shenassa
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, Maryland
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Liu LC, Wang YC, Yu MH, Su HY. Major risk factors for stillbirth in different trimesters of pregnancy--a systematic review. Taiwan J Obstet Gynecol 2015; 53:141-5. [PMID: 25017256 DOI: 10.1016/j.tjog.2014.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 10/25/2022] Open
Abstract
Stillbirth remains an event that has an important impact on global health issues. Different levels of health care between countries suggest that the stillbirth rate may be one of the indicators of the quality of a country's medical system. In this review, major risk factors for stillbirth will be discussed, especially in different trimesters of pregnancy. Early identification of risk factors for stillbirth and appropriate antenatal management may reduce preventable stillbirths and improve general outcomes of pregnancy.
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Affiliation(s)
- Li-Chun Liu
- Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Yu-Chi Wang
- Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Mu-Hsien Yu
- Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Her-Young Su
- Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
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Aminu M, Unkels R, Mdegela M, Utz B, Adaji S, van den Broek N. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG 2014; 121 Suppl 4:141-53. [PMID: 25236649 DOI: 10.1111/1471-0528.12995] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Annually, 2.6 million stillbirths occur worldwide, 98% in developing countries. It is crucial that we understand causes and contributing factors. METHODS We conducted a systematic review of studies reporting factors associated with and cause(s) of stillbirth in low- and middle-income countries (2000-13). Narrative synthesis to compare similarities and differences between studies with similar outcome categories. MAIN RESULTS A total of 142 studies with 2.1% from low-income settings were investigated; most report on stillbirths occurring at health facility level. Definition of stillbirth varied; 10.6% of studies (mainly upper middle-income countries) used a cut-off point of ≥22 weeks of gestation and 32.4% (mainly lower income countries) used ≥28 weeks of gestation. Factors reported to be associated with stillbirth include poverty and lack of education, maternal age (>35 or <20 years), parity (1, ≥5), lack of antenatal care, prematurity, low birthweight, and previous stillbirth. The most frequently reported cause of stillbirth was maternal factors (8-50%) including syphilis, positive HIV status with low CD4 count, malaria and diabetes. Congenital anomalies are reported to account for 2.1-33.3% of stillbirths, placental causes (7.4-42%), asphyxia and birth trauma (3.1-25%), umbilical problems (2.9-33.3%), and amniotic and uterine factors (6.5-10.7%). Seven different classification systems were identified but applied in only 22% of studies that could have used a classification system. A high percentage of stillbirths remain 'unclassified' (3.8-57.4%). CONCLUSION To build capacity for perinatal death audit, clear guidelines and a suitable classification system to assign cause of death must be developed. Existing classification systems may need to be adapted. Better data and more data are urgently needed.
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Affiliation(s)
- M Aminu
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
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Waldman M, Sheiner E, Sergienko R, Shoham-Vardi I. Can we identify risk factors during pregnancy for thrombo-embolic events during the puerperium and later in life? J Matern Fetal Neonatal Med 2014; 28:1005-9. [DOI: 10.3109/14767058.2014.944155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Liu LC, Huang HB, Yu MH, Su HY. Analysis of intrauterine fetal demise—A hospital-based study in Taiwan over a decade. Taiwan J Obstet Gynecol 2013; 52:546-50. [DOI: 10.1016/j.tjog.2013.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 07/16/2013] [Indexed: 10/25/2022] Open
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