title: A perinatal review of singleton stillbirths in an Australian metropolitan tertiary centre.
abstract: It is estimated that everyday 7000 women worldwide have their pregnancy end with a stillbirth, however, research and data collection on stillbirth remains underfunded. This stillbirth case series audit investigates an apparent rise in stillbirths at a Sydney tertiary referral hospital in Australia. A retrospective case series of singleton stillbirths from 2005-2010 was conducted at Westmead Hospital. Stillbirth was defined as per the Perinatal Society of Australia and New Zealand classification as a death of a baby before or during birth, from the 20th week of pregnancy onwards, or a birth weight of 400 grams or more if gestational age is unknown. A total of 215 singleton stillbirths were identified in a cohort of 28 109, a rate of 7.6 per 1000 singleton births. There was a significant increase in annual stillbirth rate at our institution; the rate exceeded both Australian national and state singleton stillbirth rates. After pregnancy terminations over 20 weeks were excluded from the data, there was no statistical change in the stillbirth rate over time. Congenital anomalies (27%) and unexplained antepartum death (15%) remained as major causes; fetal growth restriction (17%) was also identified as an increasingly important cause, particularly in preterm gestations. Termination of pregnancy after 20 weeks was found to be the cause of rising stillbirth rate at our institution. Local and national data collection on stillbirth should be standardised and should include differentiation of termination of pregnancy as a separate entity so as to accurately assess stillbirth to target appropriate research and resource allocation.
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Supuni
authors.initials: S
authors.lastname: Kapurubandara
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Sarah J
authors.identifier: http://orcid.org/0000-0002-7569-1016
authors.initials: SJ
authors.lastname: Melov
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Evangeline R
authors.initials: ER
authors.lastname: Shalou
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Monika
authors.initials: M
authors.lastname: Mukerji
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Yim
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Ujvala
authors.initials: U
authors.lastname: Rao
authors.affiliation: Liverpool Hospital, Sydney, New South Wales, Australia.
authors.forename: Zain
authors.initials: Z
authors.lastname: Battikhi
authors.affiliation: Nepean Hospital, Sydney, New South Wales, Australia.
authors.forename: Nirusha
authors.initials: N
authors.lastname: Karunaratne
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Roshini
authors.initials: R
authors.lastname: Nayyar
authors.affiliation: Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Thushari I
authors.initials: TI
authors.lastname: Alahakoon
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D001724:Birth Weight; D002423:Cause of Death; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008423:Maternal Age; D018743:Perinatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult