327: Stillbirth and prenatal vitamin supplementation: Analysis from the Stillbirth Collaborative Research Network (SCRN)

Abstract

To evaluate the association between prenatal vitamin use and stillbirth (SB). The SCRN was a case-control study conducted between 2003-2008 to determine the risk factors and causes of SB. A total of 2595 women (663 SB, 1932 live births) were enrolled. Over the counter (OTC) vitamin usage was reported via questionnaires, while vitamin prescription was assed via medical record review. Individuals were considered to have taken vitamins if they used prenatal multivitamin, iron, folic acid, or other. Any vitamin usage was categorized if the mother took prescription vitamins, OTC vitamins, or both. Causes of stillbirth were previously categorized and reported using the INCODE system. Within each category, reasons for stillbirth were identified as either probable, possible, present, or absent. Chi-square and univariate logistic regression were used for statistical analyses. SB was found to be correlated with prescribed vitamin use (p=0.000), OTC vitamin (p=0.001) and any vitamin (p=0.000) consumption, with higher proportions of all vitamin usage among Live Births. Prescription, OTC, or any vitamin usage was show to have lower odds of SB (see table, p<.001). There was no significant relationship between OTC and prescription vitamin use and identified causes of stillbirth, such as placental disease (p=0.42, p=0.37), infection (p=0.36, p=0.79), fetal genetic or structural abnormalities (p=0.89, p=0.46), maternal medical complications (p=0.77, p=0.17), hypertensive disorders (p=0.35, p=0.78), umbilical cord abnormalities (p=0.96, p=0.77), obstetric complications (p=0.31, p=0.18) or other unspecified causes (p=0.73, p=0.86). Those who consumed two types of OTC vitamins had lower odds of SB than singular consumption (OR=0.68, p=0.001), but there were no protective effects for consumption of higher volumes of vitamins. Both OTC and prescribed vitamin usage decreased the odds of SB. However, we did not identify a relationship between causes of stillbirth and prescription nor OTC vitamin usage.