Stillbirth at term: a regional prospective case-control study over the 8-year period

Objective. Intensified efforts to identify the risk factors for stillbirth (SB) are needed to reduce its rate. The aim of the study is to assess the risk factors for SB in late pregnancy.
Materials and Methods. This is a prospective case-control study conducted in Emilia-Romagna (Italy) on pregnant women at ≥ 37 weeks referred to the Obstetric Units from 2014 to 2021. The case group consisted of all cases of SB; the live births in the same period were included in the control group. We compared the information about risk factors for SB and conducted a descriptive analysis about the cause of SB according to the modified Re.CoDe. classification.
Results. From 2014 to 2021, the SB rate in Emilia-Romagna was 3.27 per 1000 births. The risk factors significantly associated with SB at term were maternal foreign origin, high education level, overweight, a previous SB, and low neonatal weight. There was no association between the two groups regarding the other risk factors analysed (Table 1). 26.1% of SB remained unclassified. The more frequent causes of death were placental (23.7%) and umbilical cord pathology (22.2%). Infections, foetal and maternal pathology were responsible for a smaller number of cases (9.3%, 8.9% and 3.5% respectively). The main causes in the last two categories were IUGR and diabetes (12 and 8 cases respectively).
Conclusions. Our study confirms what has already been described in literature. The detection rate of late IUGR and the management of pregnancy with diabetes, overweight and a previous SB need to be improved to prevent SB at term.