title: Histological chorioamnionitis is increased at extremes of gestation in stillbirth: a population-based study.
abstract: OBJECTIVE
  To determine the incidence of histological chorioamnionitis and a fetal response in stillbirths in New South Wales (NSW), and to examine any relationship of fetal response to spontaneous onset of labour and to unexplained antepartum death.
  
  
  METHODS
  Population-based cohort study. Setting. New South Wales Australia. Population. All births between 2002 and 2004 with stillbirths reviewed and classified by the state perinatal mortality review committee.
  
  
  METHODS
  Record linkage of the Midwives Data Collection and the Perinatal Death Database including placental histopathology and standardised cause of death classification.
  
  
  RESULTS
  952 stillbirths were included. The incidence of histopathological chorioamnionitis was 22.6%, with a bimodal distribution. A fetal inflammatory response was present in 10.1% and significantly correlated with spontaneous onset of labour. The absence of a fetal inflammatory response was strongly associated with unexplained antepartum death.
  
  
  CONCLUSIONS
  The increased incidence of histological chorioamnionitis at extremes of gestation is confirmed in the largest dataset to date using population data. This has important implications for late gestation stillbirth as the percentage of unexplained stillbirths increases near term.
authors.affiliation: Department of Neonatal Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia. adrienne.gordon@email.cs.nsw.gov.au
authors.forename: Adrienne
authors.initials: A
authors.lastname: Gordon
authors.forename: Monica
authors.initials: M
authors.lastname: Lahra
authors.forename: Camille
authors.initials: C
authors.lastname: Raynes-Greenow
authors.forename: Heather
authors.initials: H
authors.lastname: Jeffery
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D002821:Chorioamnionitis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D016018:Least-Squares Analysis; D011247:Pregnancy; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult