title: Causes of stillbirth in a socioeconomically disadvantaged urban Australian population - a comprehensive analysis.
abstract: BACKGROUND
  The aim of this paper was to provide an in-depth analysis of all stillbirth causation over a period of 10 years in a busy maternity unit located in a socioeconomically disadvantaged urban area, with an emphasis on overlapping pathology.
  
  
  METHODS
  A retrospective analysis of all structurally normal stillbirths in singleton pregnancies born during 2002-2012. The PSANZ stillbirth classification was used; per stillbirth subgroup main risk factors were evaluated.
  
  
  RESULTS
  Out of 130 cases, 43% showed overlapping pathologies. In the remaining 74 (56%) cases, the following single pathologies were found: IUGR 20 (15%), infection 12 (9%), abruption 8 (6%), placental thrombotic pathology 8 (6%), miscellaneous 6 stillbirths (5%), and 20 cases (15%) unexplained. Smoking was a risk factor for stillbirth associated with abruption (OR 3.639), infection (OR 2.271), and thrombotic pathology (OR 2.168). Drug use had an association with (placental) infection (OR 3.598). Obesity showed a significant association with IUGR (OR 3.782) and abruption (OR 9.040). Thrombophilia risk analysis for the overall group of stillbirths showed significant results for Protein S (OR 8.889) and homocysteine >90th centile (OR 2.087).
  
  
  CONCLUSIONS
  Overlapping pathology was identified in 43% of stillbirths. Infection, IUGR, and abruption were the most important single cause of stillbirth.
authors.affiliation: a Women and Children's Division , Lyell McEwin Hospital, Robinson Institute, University of Adelaide , Adelaide , Australia.
authors.forename: Laura Anna
authors.initials: LA
authors.lastname: Wijs
authors.affiliation: a Women and Children's Division , Lyell McEwin Hospital, Robinson Institute, University of Adelaide , Adelaide , Australia.
authors.forename: Esti Charlotte
authors.initials: EC
authors.lastname: de Graaff
authors.affiliation: b University of Adelaide , Adelaide , Australia.
authors.forename: Shalem
authors.initials: S
authors.lastname: Leemaqz
authors.affiliation: c Department of Obstetrics & Gynaecology , University of Adelaide , Adelaide , Australia.
authors.forename: Gustaaf
authors.initials: G
authors.lastname: Dekker
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data*
keywords: Australia; Stillbirth; causes