title: Risk factors for stillbirth in a socio-economically disadvantaged urban Australian population.
abstract: BACKGROUND
  Several risk factors for stillbirth have been extensively investigated. Some risk factors are more common in socio-economically disadvantaged regions. The aim of this study was to identify risk factors for stillbirth in the Northern suburbs of Adelaide, one of the most socio-economically disadvantaged urban areas in Australia.
  
  
  METHODS
  A retrospective case control study (two controls per case) of all women with a singleton pregnancy resulting in a stillbirth during the decade 2002-2012.
  
  
  RESULTS
  One hundred and thirty stillbirths were registered over these 10 years. Using univariate analysis, the following risk factors were identified: obesity ≥40 body mass index (BMI) (OR 4.75), non-Caucasian ethnicity (odds ratio [OR] 2.737), pre-existing diabetes (p <0.000), polycystic ovary syndrome (PCOS) (OR 5.250), in vitro fertilisation (IVF) (OR 4.000), booking systolic blood pressure (SBP) ≥ 140 (OR 5.000) and booking diastolic blood pressure (DBP) ≥ 80 (OR 3.111). Many of these factors have complex interrelationships. Multivariate analysis identified the following independent risk factors: BMI ≥40 (OR 3.940), ethnic minorities (mainly indigenous Australians) (OR 2.255) and social issues (OR 3.079). PCOS had an independent effect to some extent, but this was clearly confounded by BMI.
  
  
  CONCLUSIONS
  These Australian data confirm the presence of several potentially modifiable risk factors for stillbirth, within this socio-economically disadvantaged region. Modifying these risk factors, in particular obesity, is a big challenge not only for maternity and primary care providers, but for overall society.
authors.affiliation: a Women and Children's Division Lyell McEwin Hospital , University of Adelaide (Robinson Institute) , Adelaide , Australia.
authors.forename: E C
authors.initials: EC
authors.lastname: de Graaff
authors.affiliation: a Women and Children's Division Lyell McEwin Hospital , University of Adelaide (Robinson Institute) , Adelaide , Australia.
authors.forename: L A
authors.initials: LA
authors.lastname: Wijs
authors.affiliation: a Women and Children's Division Lyell McEwin Hospital , University of Adelaide (Robinson Institute) , Adelaide , Australia.
authors.forename: S
authors.initials: S
authors.lastname: Leemaqz
authors.affiliation: a Women and Children's Division Lyell McEwin Hospital , University of Adelaide (Robinson Institute) , Adelaide , Australia.
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015233:Models, Statistical; D015999:Multivariate Analysis; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D050497:Stillbirth / Q000453:epidemiology*; D014504:Urban Health / Q000706:statistics & numerical data*; D035862:Vulnerable Populations
keywords: Australia; risk factor; stillbirth