title: Mode of Delivery in Stillbirth, 1995-2004.
abstract: OBJECTIVE
  There are no national reports on the mode of delivery in pregnancies that end in stillbirth. We aimed at analyzing the cesarean delivery rates in pregnancies resulting in stillbirth over a 10-year period in the United States.
  
  
  METHODS
  This was a retrospective analysis evaluating data from the 1995 to 2004 US linked live birth-infant death files reported by the National Center for Health Statistics to examine the cesarean delivery rates in singleton pregnancies with and without stillbirth.
  
  
  RESULTS
  There were 39 797 616 singleton births registered in the database after the 20th week of gestation. During the study period, there were 243 979 stillbirths (0.61 per 100). Significant differences in stillbirths were noted in the African American population, nonmarried patients, in mothers who smoked, and at the extremes of the patients reproductive age (P < .01). The overall cesarean delivery rate in liveborn was 23.54% (9 309 961 cases) and 10.5% in stillbirth (25 558 cases; P < .01). The rate of cesarean delivery increased in liveborn (from 20.8% in 1995 to 28.9% in 2004; 28% overall increase) and in stillbirth (9.5% in 1995 to 11.23% in 2004; 15% overall increase). The rates of primary and repeat cesarean operations increased with gestational age in the stillbirth group. This pattern was not observed in the liveborn group.
  
  
  CONCLUSIONS
  This analysis indicates that the cesarean delivery rates increased both in liveborn and in stillbirth from 1995 to 2004. This epidemiological observation deserves new clinical investigations to understand the clinical reasons, driving this obstetrical practice and the financial and societal impact that it portends.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Valeria Di
authors.initials: VD
authors.lastname: Stefano
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA The Perinatal Institute, Jersey Shore University Medical Center, Neptune, NJ 07753, USA jsantolaya@meridianhealth.com.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Santolaya-Forgas
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Revital
authors.initials: R
authors.lastname: Faro
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Duzyj
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA The Perinatal Institute, Jersey Shore University Medical Center, Neptune, NJ 07753, USA.
authors.forename: Yinka
authors.initials: Y
authors.lastname: Oyelese
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D036801:Parturition; D011247:Pregnancy; D012189:Retrospective Studies; D050497:Stillbirth; D014481:United States
keywords: cesarean section; fetal demise; high-risk pregnancies; primary cesarean delivery; repeat cesarean delivery; stillbirth