Abstract
(1) Background: Across Europe, the incidence of antepartum stillbirth varies greatly, partly because of heterogeneous definitions regarding gestational weeks and differences in legislation. With this study, we sought to provide a comprehensive overview on the demographics of antepartum stillbirth in Austria, defined as non-iatrogenic fetal demise ≥22+0 gestational weeks (/40). (2) Methods: We conducted a population-based study on epidemiological characteristics of singleton antepartum stillbirth in Austria between January 2008 and December 2020. Data were derived from the validated Austrian Birth Registry. (3) Results: From January 2008 through December 2020, the antepartum stillbirth rate ≥20+0/40 was 3.10, ≥22+0/40 3.14, and ≥24+0/40 2.83 per 1000 births in Austria. The highest incidence was recorded in the federal states of Vienna, Styria, and Lower and Upper Austria, contributing to 71.9% of all stillbirths in the country. In the last decade, significant fluctuations in incidence were noted: from 2011 to 2012, the rate significantly declined from 3.40 to 3.07‰, whilst it significantly increased from 2.76 to 3.49‰ between 2019 and 2020. The median gestational age of antepartum stillbirth in Austria was 33+0 (27+2–37+4) weeks. Stillbirth rates ≤26/40 ranged from 164.98 to 334.18‰, whilst the lowest rates of 0.58–8.4‰ were observed ≥36/40. The main demographic risk factors were maternal obesity and low parity. (4) Conclusions: In Austria, the antepartum stillbirth rate has remained relatively stable at 2.83–3.10 per 1000 births for the last decade, despite a significant decline in 2012 and an increase in 2020.
Highlights
Live birth rates and perinatal mortality statistics are considered two of the paramount parameters which shape national demographics and reflect the general population qualities and public health standards within a system
While the antepartum stillbirth rate was the highest in Vienna, demographics show no significant difference regarding maternal age or BMI compared to other states in Austria; smoking has been more commonly registered among Viennese women
The highest fluctuation over time was observed at weeks 22 and 23, with a discrepancy in prevalence of standard error of the mean (SEM) 25.52 (328.8 ± 92.0; p < 0.0001) and SEM 28.07 (271.9 ± 101.2; p < 0.0001), respectively
Summary
Live birth rates and perinatal mortality statistics are considered two of the paramount parameters which shape national demographics and reflect the general population qualities and public health standards within a system. Whilst these may differ grossly between low- and high-income countries across the world, basic characteristics in live birth and stillbirth rates are approximately similar within Europe [1]. The differences in the legislation of perinatal mortality statistics primarily concern definitions of stillbirth with regard to gestational age of delivery, birth weight, and timing or way of demise. We set out to assess regional differences in antepartum stillbirths and evaluate potential risk factors in the Austrian population
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