title: Trends in intrapartum fetal death, 1979-2003.
abstract: OBJECTIVE
  This study was undertaken to analyze trends in intrapartum fetal death and rates of perinatal autopsy over a 25-year period in Dublin, Ireland.
  
  
  METHODS
  A retrospective multicenter analysis of 508,342 nonanomalous infants 500 g or more, delivering in 3 tertiary-referral university institutions between 1979-2003.
  
  
  RESULTS
  There has been a significant downward trend in the rate of intrapartum fetal death over the past 25 years (P < .0001). Nulliparous labors were statistically more likely to be complicated by an intrapartum fetal demise than parous labors (odds ratio, 1.49; 95% confidence interval [CI], 1.16-1.92; P = .0018). Intrapartum deaths secondary to hypoxia fell significantly over the study period (P < .0001). Infants of multiple gestations were twice as likely to die in labor as singletons (odds ratio, 2.2; 95% CI, 1.22-3.74; P = .0058). Rates of perinatal autopsy fell significantly over the 25 years studied (P < .0001).
  
  
  CONCLUSIONS
  There has been a significant fall in rates of intrapartum fetal death. This has primarily resulted from a reduction in deaths attributable to intrapartum hypoxia. Infants of multiple gestations still retain a significantly higher chance of intrapartum death. The fall in uptake rates of perinatal autopsy in recent years is concerning.
authors: Department of Obstetrics and Gynaecology, the Rotunda Hospital, Dublin, Ireland.
authors: Colin A
authors: CA
authors: Walsh
authors: Moya B
authors: MB
authors: McMenamin
authors: Michael E
authors: ME
authors: Foley
authors: Sean F
authors: SF
authors: Daly
authors: Michael S
authors: MS
authors: Robson
authors: Michael P
authors: MP
authors: Geary
mesh_terms: D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D016001:Confidence Intervals; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D046689:Fetal Mortality / Q000639:trends*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011272:Pregnancy, Multiple; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors