title: Causes of Stillbirth in Turku, Finland, 2001-2011.
abstract: The objective of the study was to examine the causes of stillbirth in the district of Southwest Finland and to assess the importance of postmortem examination and the selection of a suitable classification system for classifying stillbirths. This study is a cohort study where the fetal autopsies were performed in the Department of Pathology at Turku University Hospital, Finland, 2001-2011. Stillbirths from singleton pregnancies at the gestational age of ≥ 24 + 0 weeks (if unknown, gestational weight ≥ 500 g) (n = 98) were selected. In addition, stillbirths from multiple gestations (n = 6) were also analyzed. The causes of stillbirths were classified according to the Relevant Condition at Death classification system. Maternal risk factors and the role of fetal gestational age and weight for the causes of stillbirth were assessed. The most common causes of singleton stillbirth were lethal congenital anomalies, placental insufficiencies, and constricting loops and knots of the umbilical cord. The cause of singleton stillbirth could be determined for 78% of the cases, leaving 22% unclassified. There were no significant differences in the causes of stillbirth by gestational age or weight. Smoking may increase the incidence of placental abruption ( P < 0.01). The most common causes of stillbirth in Turku, Finland, are consistent with findings from other high-income countries. With careful postmortem examination and ancillary studies, it is possible to find the cause of stillbirth for most of the cases. Even if the stillbirth is left unexplained, many other harmful conditions can be excluded thus benefiting both the parents and the health care unit.
authors.affiliation: 1 Department of Pathology, University of Turku and TYKS-SAPA, Turku University Hospital, Turku, Finland.
authors.forename: Tanita
authors.initials: T
authors.lastname: Lehtonen
authors.affiliation: 1 Department of Pathology, University of Turku and TYKS-SAPA, Turku University Hospital, Turku, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Markkula
authors.affiliation: 1 Department of Pathology, University of Turku and TYKS-SAPA, Turku University Hospital, Turku, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Soidinsalo
authors.affiliation: 2 Department of Obstetrics and Gynecology, Satakunta Central Hospital, Pori, Finland.
authors.forename: Saara
authors.initials: S
authors.lastname: Otonkoski
authors.affiliation: 1 Department of Pathology, University of Turku and TYKS-SAPA, Turku University Hospital, Turku, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Laine
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult
keywords: classification; fetal growth restriction; gestational age; maternal smoking; placental abruption; postmortem examination; stillbirth