title: Screening and prevention of stillbirth.
abstract: Stillbirth is delivery of a baby at or after 24 weeks of gestational age (UK definition) not showing any signs of life. It affects almost one in 200 pregnancies and is the single major cause of perinatal death. Stillbirth is associated with a wide range of maternal demographic characteristics, but most of the variations in stillbirth risk are independent of these characteristics. Stillbirth is the end point of multiple processes, but the single most common cause is probably placental dysfunction. Stillbirth is associated with a wide range of biochemical and ultrasonic predictors, but there is limited evidence to support population-based screening. However, the evidence based is weak due to the use of poorly characterised screening tests, the failure to couple risk assessment with a clearly effective intervention for those who screen positive and inadequate study sample sizes. Basic research needs to identify better predictors, and clinical trials need to adopt more rigorous methodologies.
authors.affiliation: Professor & Head of the Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, CB2 0SW, UK. Electronic address: gcss2@cam.ac.uk.
authors.forename: Gordon C S
authors.initials: GC
authors.lastname: Smith
mesh_terms: D000017:ABO Blood-Group System; D000022:Abortion, Spontaneous / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D002585:Cesarean Section; D036861:Delivery, Obstetric; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D008423:Maternal Age; D009765:Obesity / Q000453:epidemiology; D010298:Parity; D066087:Perinatal Death / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011272:Pregnancy, Multiple; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011296:Prenatal Diagnosis; D018570:Risk Assessment; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014028:Tobacco Smoke Pollution; D016216:Ultrasonography, Prenatal; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000017:ABO Blood-Group System; D014028:Tobacco Smoke Pollution; D000509:alpha-Fetoproteins; D011266:Pregnancy-Associated Plasma Protein-A
keywords: biomarkers; intervention; screening; stillbirth; ultrasound