Intrauterine infection may be a major cause of stillbirth in Sweden.
OBJECTIVE
To investigate intrauterine infection as a cause for unexplained stillbirth.


METHODS
Chorioamnionitis was studied in a material of stillbirths (117 subjects from the years 1985-1994) from a region in the south Sweden. Control material (126 alive and healthy newborns and with healthy mothers) was gathered from the same region.


RESULTS
Chorioamnionitis was a common diagnosis both with stillbirths and 'healthy' deliveries (82 and 68%, respectively). Extension of the inflammation to decidua basalis was seven times more common among stillbirths than among controls (odds ratio 7.2, confidence interval 2.8-21.9). The most common bacteria found at cultures were Escherichia coli, Coagulase negative staphylococcus, Enterococcus faecalis and group B Streptococcus. The risk for stillbirth was doubled if both inflammation and bacteria were present (odds ratio 2.3, confidence interval 0.92-5.8). Meconium discharge was more common among stillbirths than controls (odds ratio=4.7, confidence interval 1.7-14). There were no differences in any respect regarding macerated and non-macerated stillbirths. Our findings are similar to the results from studies in developing countries except for the higher incidence of stillbirths in such countries.


CONCLUSIONS
Thus, a large part of otherwise unexplained stillbirths might be due to ascending infections.
Tolockiene
E
E
Department of Pathology, University of Lund, Lund, Sweden.
Morsing
E
E
Holst
E
E
Herbst
A
A
Ljungh A
Svenningsen
N
N
Hägerstrand
I
I
Nyström
L
L
D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000453:epidemiology* / Q000382:microbiology; D015897:Comorbidity; D016001:Confidence Intervals; D046508:Culture Techniques; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology