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Am J Perinatol 2020; 37(07): 708-715
DOI: 10.1055/s-0039-1688472
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Findings in Stillbirths Associated with Placental Disease

Karen J. Gibbins 
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon
,
Halit Pinar
2   Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Uma M. Reddy
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut
,
George R. Saade
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Robert L. Goldenberg
5   Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York
,
Donald J. Dudley
6   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia
,
Carolyn Drews-Botsch
7   Department of Epidemiology, Emory University, Atlanta, Georgia
,
Alexa Ann Freedman
7   Department of Epidemiology, Emory University, Atlanta, Georgia
,
Lauren M. Daniels
7   Department of Epidemiology, Emory University, Atlanta, Georgia
,
Corette B. Parker
8   RTI International, Durham, North Carolina
,
Vanessa Thorsten
8   RTI International, Durham, North Carolina
,
Radek Bukowski
9   Department of Women’s Health, University of Texas at Austin, Austin, Texas
,
Robert M. Silver
10   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
› Author Affiliations Funding This study was supported by grants (HD45925, HD45944, HD45952, HD45953, HD45954, and HD45925) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. KJG received support from the University of Utah WRHR program 1K12HD085816 NICHD.
Further Information

Publication History

26 November 2018

22 March 2019

Publication Date:
14 May 2019 (online)

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Abstract

Objective Placental disease is a leading cause of stillbirth. Our purpose was to characterize stillbirths associated with placental disease.

Study Design The Stillbirth Collaborative Research Network conducted a prospective, case–control study of stillbirths and live births from 2006 to 2008. This analysis includes 512 stillbirths with cause of death assignment and a comparison group of live births. We compared exposures between women with stillbirth due to placental disease and those due to other causes as well as between women with term (≥ 37 weeks) stillbirth due to placental disease and term live births.

Results A total of 121 (23.6%) out of 512 stillbirths had a probable or possible cause of death due to placental disease by Initial Causes of Fetal Death. Characteristics were similar between stillbirths due to placental disease and other stillbirths. When comparing term live births to stillbirths due to placental disease, women with non-Hispanic black race, Hispanic ethnicity, lack of insurance, or who were born outside of the United States had higher odds of stillbirth due to placental disease. Nulliparity and antenatal bleeding also increased risk of stillbirth due to placental disease.

Conclusion Multiple discrete exposures were associated with stillbirth caused by placental disease. The relationship between these factors and utility of surveillance warrants further study.

Keywords

placental disease - stillbirth - placental insufficiency - placental pathology
 

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