Stillbirth and Live Birth at Periviable Gestational Age: A Comparison of Prevalence and Risk Factors

Carmichael, Suzan L.; Blumenfeld, Yair J.; Mayo, Jonathan A.; Profit, Jochen; Shaw, Gary M.; Hintz, Susan R.; Stevenson, David K.

doi:10.1055/s-0038-1670633

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…Among the 16 studies that provided effect estimates for IPI <6 months following any previous pregnancy outcome, six reported a modest increase in risk of perinatal death compared with longer IPIs, 6,25,[32][33][34][35] half of which were from LMICs 25,32,33 (see Supplementary material, Table S4). Adjusted odds ratios (aOR) of perinatal death associated with IPI <6 months ranged from 1.54 (95% CI 1.28-1.83) 33 11,35 Of the six studies that examined IPI following a previous miscarriage (LMIC: 3 and HIC: 3), 25,[36][37][38][39][40] one study from Egypt identified a significant increase in the adjusted odds of perinatal death for IPI <6 months compared with IPI >12 months (aOR 2.49; 95% CI 1.00-3.90) 37 (see Supplementary material, Table S4).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 11 studies that provided adjusted estimates measuring the association between longer IPIs and risk of perinatal death, six reported a harmful association. 11,15,33,34,42,43 Of the three studies reporting on IPI ≥60 months after any previous pregnancy outcome in LMICs, one identified an increase in the odds of perinatal death compared with an IPI of 18-23 months (aOR 1.21; 95% CI 1.15-1.27). 33 The other two studies from LMICs did not identify this association (aOR 0.75; 95% CI 0.22-2.57 and aOR 1.07; 95% CI 0.87-1.32).…”

Section: Resultsmentioning

confidence: 99%

“…13,44 Two HIC studies reported on longer IPIs after any previous pregnancy outcome. Carmichael et al 34 reported an adjusted odds ratio of 1.28 (95% CI 1.14-1.44) associated with IPI ≥48 months compared with 6-23 months. Stephansson et al 43 reported an adjusted OR of 1.2 (95% CI 1.0-1.4) after an IPI of 36-71 months and 1.5 (95% CI 1.1-2.1) after an IPI ≥72 months.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 16 studies that provided effect estimates for IPI <6 months following any previous pregnancy outcome, six reported a modest increase in risk of perinatal death compared with longer IPIs, 6,25,32–35 half of which were from LMICs 25,32,33 (see Supplementary material, Table S4). Adjusted odds ratios (aOR) of perinatal death associated with IPI <6 months ranged from 1.54 (95% CI 1.28–1.83) 33 to 2.09 (95% CI 1.75–2.46) 32 in LMICs, translating to a 3.1–3.4% absolute increase in the risk of perinatal death.…”

Section: Resultsmentioning

confidence: 99%

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Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

Regan

Arnaout

Marinovich

et al. 2020

BJOG

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Background Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes. Objective This systematic review evaluated the international literature on the risk of perinatal death associated with IPI. Search strategy Two independent reviewers screened titles and abstracts identified in MEDLINE, EMBASE and Scopus from inception to 4 April 2019 (Prospero Registration #CRD42018092792). Selection criteria Studies were included if they provided a description of IPI measurement and perinatal death, including stillbirth and neonatal death. Data collection and analysis A narrative review was performed for all included studies. Random effects meta-analysis was used to compare unadjusted odds of perinatal death associated with IPI <6 months and IPI ≥6 months. Analyses were performed by outcome of the preceding pregnancy and study location. Main results Of the 624 unique articles identified, 26 met the inclusion criteria. The pooled unadjusted odds ratio of perinatal death for IPI <6 months was 1.34 (95% CI 1.17-1.53) following a previous live birth, 0.85 (95% CI 0.73-0.99) following a previous miscarriage and 1.07 (95% CI 0.84-1.36) following a previous stillbirth compared with IPI ≥6 months. However, few high-income country studies reported an association after adjustment. Fewer studies evaluated the impact of long IPI on perinatal death and what evidence was available showed mixed results. Conclusions Results suggest a possible association between short IPI and risk of perinatal death following a live birth, particularly in low-to middle-income countries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Among the 16 studies that provided effect estimates for IPI <6 months following any previous pregnancy outcome, six reported a modest increase in risk of perinatal death compared with longer IPIs, 6,25,32–35 half of which were from LMICs 25,32,33 (see Supplementary material, Table S4). Adjusted odds ratios (aOR) of perinatal death associated with IPI <6 months ranged from 1.54 (95% CI 1.28–1.83) 33 to 2.09 (95% CI 1.75–2.46) 32 in LMICs, translating to a 3.1–3.4% absolute increase in the risk of perinatal death.…”

Section: Resultsmentioning

confidence: 99%

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Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

Regan

Arnaout

Marinovich

et al. 2020

BJOG

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“…Prepregnancy medical conditions (preexisting diabetes and preexisting hypertension) and obstetric characteristics (preeclampsia, gestational diabetes, and gestational hypertension) were defined using ICD-9-CM diagnosis codes in the delivery hospitalization (Appendix 3 available online at http://links.lww.com/AOG/B446, lists specific ICD-9-CM codes). 13–15…”

Section: Methodsmentioning

confidence: 99%

Severe Maternal Morbidity Among Stillbirth and Live Birth Deliveries in California

Wall‐Wieler

Carmichael

Gibbs

et al. 2019

Obstetrics &Amp; Gynecology

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OBJECTIVE: To assess the prevalence and risk of severe maternal morbidity among delivery hospitalization for stillbirth compared with live birth deliveries. METHODS: Using data from the Office of Statewide Health Planning and Development in California, we performed a population-based cross-sectional study of 6,459,842 deliveries between 1999 and 2011. We identified severe maternal morbidity using an algorithm comprising diagnoses and procedures developed by the Centers for Disease Control and Prevention and used logbinomial regression models to examine the relative risk (RR) of severe maternal morbidity for stillbirth compared with live birth deliveries, adjusting for maternal demographic, medical, and obstetric characteristics. We also examined severe maternal morbidity prevalence by cause of fetal death among stillbirth deliveries. RESULTS: The prevalence of severe maternal morbidity for stillbirth and live birth was 578 and 99 cases per 10,000 deliveries, respectively. After adjusting for maternal demographic, medical, and obstetric characteristics, the risk of severe maternal morbidity among stillbirth deliveries was more than fourfold higher (adjusted RR 4.77; 95% CI 4.53-5.02) compared with live birth deliveries. The severe maternal morbidity prevalence was highest among stillbirths caused by hypertensive disorders and placental conditions (24 and 19 cases/100 deliveries, respectively), and lowest among stillbirths caused by fetal malformations or genetic abnormalities (1 case per 100 deliveries). CONCLUSION: Women who have stillbirths are at substantially higher risk for severe maternal morbidity than women who have live births, regardless of cause of fetal death. The prevalence of severe maternal morbidity varies by cause of fetal death. Reducing the national rates of maternal mortality and severe maternal morbidity is an obstetric priority in the United States. Recent data indicate that the rate of maternal mortality in the United States is substantially higher than other well-resourced developed countries. 1 Furthermore, the prevalence of severe maternal morbidity has increased steadily in the

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The Association of Ambient Temperature with Extremely Preterm Births

Vilcins

Baker

Jagals

et al. 2021

Matern Child Health J

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Introduction Extremely preterm births (EPT), require complex decision making and significant medical interventions. While environmental factors such as ambient temperature extremes have been associated with preterm births, little is known of the environmental associations with EPT births. The objective of this study is to explore whether ambient temperature is associated with increased risk of EPT birth. Methods Birth records for 315,226 infants born in Queensland Australia (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) were matched to average maximum and minimum temperature for the last month of pregnancy. Odds ratios and 95% confidence intervals were calculated using a generalised linear model. Population attributable risk was calculated for a 5% reduction in maximum temperature. Results Each one degree increase in maximum [aOR 1.03 (95% CI 1.01, 1.05)] and minimum temperature [aOR 1.02 (95% CI 1.01, 1.04)] was associated with an increase in odds for EPT birth. Increased odds for EPT births was found for maternal smoking [aOR 1.46 (95% CI 1.23, 1.72)], increasing plurality [OR 6.38 (95% CI 5.48, 7.42)] and stillbirth [aOR 342.99 (95% CI 295.53, 398.06)]. When stratified by birth status, the association was only found for live births. Discussion Higher temperatures are associated with small increases in the odds of delivering an infant in the EPT period. The risk may be enhanced for women who smoke during pregnancy. Women at an increased risk of preterm births should be counselled around methods to reduce their exposure to excessive heat.

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Stillbirth and Live Birth at Periviable Gestational Age: A Comparison of Prevalence and Risk Factors

Abstract: Inclusion of stillbirths and live births in studies of deliveries at periviable gestations is important.

Cited by 11 publications

References 26 publications

Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

Severe Maternal Morbidity Among Stillbirth and Live Birth Deliveries in California

The Association of Ambient Temperature with Extremely Preterm Births

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