Stillbirth

Abstract

INTRODUCTION: Known causes of stillbirth include premature rupture of membranes, congenital anomalies, preeclampsia, and intrauterine growth restriction. Risk factors for stillbirth include age, black or Hispanic ethnicity, history of smoking, history of stillbirth, diabetes, and hypertension. The objective of this study was to determine the stillbirth rate and descriptive factors for clinics serving the a Midwestern, metropolitan community. METHODS: After receiving IRB approval, a retrospective chart review was conducted at two local, private practice obstetrical clinics. Records were reviewed for patients that experienced a stillbirth between January 1, 2007 to December 31, 2013 using ICD-9 codes: V27.1, 656.4, 674.9, 656.43, 779.9, and 651.6. Cases with a demise before 14 weeks gestation were excluded. Demographics, maternal history, antepartum care, antepartum education, and delivery information were collected. RESULTS: The stillbirth rate was 4.1 per 1,000 deliveries. Among the 78 patients included in the final analysis, average maternal age was 28.2 years (SD=7.1, range=17 to 45). Most were white (n=48, 64%), never smoked (n=50, 64.9%), and had private medical insurance (n=51, 68%). Average gestational age at delivery was 27.9 weeks (SD=7.9, range=14 to 41). Among the 45 women who experienced stillbirth after 24 weeks gestation, 12 (27.9%) reported decreased fetal movement, and most did not receive education on fetal movement (n=44, 97.8%), safe sleep (n=45, 100%), or breastfeeding (n=43, 93.3%). CONCLUSION: Prenatal education in regards to fetal movement, safe sleep, and breastfeeding was lacking. A locally designed intervention to detect fetal movement should be developed to reduce stillbirth.