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Am J Perinatol 2018; 35(13): 1271-1280
DOI: 10.1055/s-0038-1648234
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Factors Associated with Stillbirth Autopsy in Georgia and Utah, 2010–2014: The Importance of Delivery Location

Kaitlin Forsberg   *
1   Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
,
Lauren Christiansen-Lindquist
1   Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
,
Robert M. Silver
2   University of Utah Health Sciences Center, Salt Lake City, Utah
› Author Affiliations
Further Information

Publication History

01 September 2017

24 March 2018

Publication Date:
03 May 2018 (online)

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Abstract

Objective This article determines whether demographic, delivery, and medical factors are associated with stillbirth autopsy performance in Georgia and Utah.

Study Design This study used fetal death certificates from 2010 to 2014 to determine which factors are associated with stillbirth autopsy performance in Georgia and Utah. Analyses were conducted using logistic regression with a predicted margins approach.

Results The stillbirth autopsy rate was low in both states: 11.9% in Georgia (N = 5,610) and 23.9% in Utah (N = 1,425). In Utah, the autopsy rate significantly declined during the study period (p = 0.01). Stillbirths delivered outside of large metropolitan areas were less likely to receive an autopsy (medium/small metropolitans: prevalence ratioGA [PR] = 0.57, 95% confidence interval [CI]: 0.48–0.68 and PRUT = 0.48, CI: 0.38–0.59; nonmetropolitans: PRGA = 0.57, CI: 0.43–0.75 and PRUT = 0.37, CI: 0.21–0.63). In Georgia, autopsies were less common among stillbirths of Hispanic (vs. white) women (PR = 0.57, CI: 0.41–0.79), at earlier (vs. later) gestational ages (PR = 0.59, CI: 0.51–0.69), and of multiple birth pregnancies (PR = 0.71, CI: 0.53–0.96).

Conclusion Despite strong evidence supporting the value of stillbirth autopsies, autopsy rates were low, especially outside metropolitan areas, where approximately half of stillbirths were delivered.

Keywords

stillbirth - autopsy - fetal death - fetal death certificate - perinatal pathology - vital records
 

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