Epidemiology of stillbirth and strategies for its prevention in Vietnam.
OBJECTIVE
To describe major epidemiologic and placental findings regarding stillbirth in Vietnam.


METHODS
A cross-sectional study of all stillbirths in a tertiary referral facility in Ho Chi Minh City, Vietnam, was performed. Detailed examination of each infant, placental pathology, and semi-structured maternal interviews were conducted according to the Perinatal Society of Australia and New Zealand Perinatal Death Classification guidelines. Maternal, fetal, and placental characteristics were examined.


RESULTS
Between December 8, 2008, and January 9, 2009, there were 4694 live births and 122 stillbirths at the facility. In total, 107 (87.7%) cases were included in the study. Low education level was associated with a lack of prenatal care; induced abortion accounted for 34.6% of fetal deaths (gender selection was not the reason); 35.5% of infants were born at 22-28 weeks of gestation; 31.8% of stillbirths were small for gestational age; histologic evidence of chorioamnionitis was present in 40.2% of cases. Calcium supplements were less likely to have been taken in cases in which death from hypertension occurred. alpha-Thalassemia was the main cause of fetal hydrops (6.2%).


CONCLUSIONS
Improving access to prenatal care and prenatal calcium and iron supplementation, and screening for congenital abnormalities and alpha-thalassemia may help to reduce rates of perinatal death in Vietnam.
Hirst
Jane E
JE
Department of Obstetrics and Gynaecology, University of Sydney, Sydney, Australia. jhirst@med.usyd.edu.au
Arbuckle
Susan M
SM
Do
Trong M H
TM
Ha
Lieu T T
LT
Jeffery
Heather E
HE
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data; D050497:Stillbirth / Q000453:epidemiology*; D014505:Urban Population; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult