Display options
Cite
Aguinaga M, Valdespino Y, Medina D, et al. Causal analysis of fetal death in high-risk pregnancies. J Perinat Med. 2021;49(6):740-747doi: 10.1515/jpm-2020-0352.
Aguinaga, M., Valdespino, Y., Medina, D., Espino Y Sosa, S., Sevilla, R., Miranda, O., Acevedo, S., Monroy, I. E., Helguera, A. C., Pérez, J., Mariscal, L. F., Murillo, M. R., Lara, R. M., Armijos, J. C., Rogel, G., & Cardona, J. A. (2021). Causal analysis of fetal death in high-risk pregnancies. Journal of perinatal medicine, 49(6), 740-747. https://doi.org/10.1515/jpm-2020-0352
Aguinaga, Mónica, et al. "Causal analysis of fetal death in high-risk pregnancies." Journal of perinatal medicine vol. 49,6 (2021): 740-747. doi: https://doi.org/10.1515/jpm-2020-0352
Aguinaga M, Valdespino Y, Medina D, Espino Y Sosa S, Sevilla R, Miranda O, Acevedo S, Monroy IE, Helguera AC, Pérez J, Mariscal LF, Murillo MR, Lara RM, Armijos JC, Rogel G, Cardona JA. Causal analysis of fetal death in high-risk pregnancies. J Perinat Med. 2021 Mar 19;49(6):740-747. doi: 10.1515/jpm-2020-0352. Print 2021 Jul 27. PMID: 33735952.
Copy Download .nbib Format: NLM
Share it on

J Perinat Med. 2021 Mar 19;49(6):740-747. doi: 10.1515/jpm-2020-0352. Print 2021 Jul 27.

Causal analysis of fetal death in high-risk pregnancies.

Journal of perinatal medicine

Mónica Aguinaga, Yolotzin Valdespino, Daniela Medina, Salvador Espino Y Sosa, Rosalba Sevilla, Osvaldo Miranda, Sandra Acevedo, Irma E Monroy, Addy C Helguera, Javier Pérez, Luisa F Mariscal, Mauricio R Murillo, Rosa M Lara, Jessica C Armijos, Gabriela Rogel, Jorge A Cardona

Affiliations

  1. Human Genetics and Genomics Department, Instituto Nacional de Perinatología, Mexico City, Mexico.
  2. Pathology Department, Instituto Nacional de Perinatología, Mexico City, Mexico.
  3. Subdirection of Clinical Research, Instituto Nacional de Perinatología, Mexico City, Mexico.
  4. Obstetrics Department, Instituto Nacional de Perinatología, Mexico City, Mexico.
  5. Maternal Fetal Medicine Department, Instituto Nacional de Perinatología, Mexico City, Mexico.
  6. Immunobiochemistry Department, Instituto Nacional de Perinatología, Mexico City, Mexico.
  7. Instituto Nacional de Perinatología, Mexico City, Mexico.

PMID: 33735952 DOI: 10.1515/jpm-2020-0352

Abstract

OBJECTIVES: To determine the causes of fetal death among the stillbirths using two classification systems from 22 weeks of gestation in a period of three years in high-risk pregnancies. This is a retrospective observational study.

METHODS: The National Institute of Perinatal Health in Mexico City is a Level 3 care referral center attending high-risk pregnancies from throughout the country. The population consisted of patients with fetal death during a three-year period. Between January 2016 and December 2018, all stillbirths were examined in the Pathology Department by a pathologist and a medical geneticist. Stillbirth was defined as a fetal death occurring after 22 weeks of gestation.

RESULTS: Main outcome measures: Causal analysis of fetal death using the International Statistical Classification of Disease and Related Health Problems-Perinatal Mortality (ICD-PM) and initial causes of fetal death (INCODE) classification systems. A total of 297 stillborn neonates were studied. The distribution of gestational age in antepartum stillbirths (55.2%) showed a bimodal curve, 36% occurred between 24 and 27 weeks and 32% between 32 and 36 weeks. In comparison, the majority (86%) of intrapartum deaths (44.8%) were less than 28 weeks of gestation. Of the 273 women enrolled, 93 (34%) consented to a complete fetal autopsy. The INCODE system showed a present cause in 42%, a possible cause in 54% and a probable cause in 93% of patients.

CONCLUSIONS: The principal causes of antepartum death were fetal abnormalities and pathologic placental conditions and the principal causes of intrapartum death were complications of pregnancy which caused a premature labor and infections.

© 2021 Walter de Gruyter GmbH, Berlin/Boston.

Keywords: antepartum; causal analysis; fetal death; intrapartum

References

  1. Froen, JF, Cacciatore, J, McClure, EM, Kuti, O, Hakeem, A, Islam, M, et al.. Stillbirths: why they matter. Lancet 2011;377:1353–66. https://doi.org/10.1016/S0140-6736(10)62232-5. - PubMed
  2. UNICEF, WHO. Every newborn: an action plan to end preventable deaths. Geneva: WHO; 2014. - PubMed
  3. INEGI. Instituto Nacional de Estadística y Geografía. Mortalidad fetal. Available from: http://www.inegi.org.mx/lib/olap/consulta/general_ver4/MDXQueryDatos.asp?proy=mortfet_mf. - PubMed
  4. Reinebrant, HE, Leisher, SH, Coory, M, Henry, S, Wojcieszek, AM, Gardener, G, et al.. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG 2018;125:212–24. https://doi.org/10.1111/1471-0528.14971. - PubMed
  5. Page, JM, Christiansen-Lindquist, L, Thorsten, V, Parker, CB, Reddy, UM, Dudley, DJ, et al.. Diagnostic tests for evaluation of stillbirth: results from the stillbirth collaborative research network. Obstet Gynecol 2017;129:699–706. https://doi.org/10.1097/aog.0000000000001937. - PubMed
  6. Korteweg, F, Erwich, JJ, Timmer, A, van der Meer, J, Ravisé, J, Veeger, N, et al.. Evaluation of 1025 fetal deaths: proposed diagnostic workup. Am J Obstet Gynecol 2012;206:53.e1–12. https://doi.org/10.1016/j.ajog.2011.10.026. - PubMed
  7. Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. J Am Med Assoc 2011;306:2459–68. - PubMed
  8. Korteweg, F, Erwich, JJ, Holm, J, Raivisé, J, van der Meer, J, Veeger, N, et al.. Diverse placental pathologies as the main cause of fetal death. Obstet Gynecol 2009;114:809–17. https://doi.org/10.1097/aog.0b013e3181b72ebe. - PubMed
  9. Faye-Petersen, OM, Guinn, DA, Wenstrom, KD. Value of perinatal autopsy. Obstet Gynecol 1999;94:915–20. https://doi.org/10.1097/00006250-199912000-00003. - PubMed
  10. Dudley, DJ, Goldenberg, R, Conway, D, Silver, R, Saade, G, Varner, M, et al.. A new system for determining the causes of stillbirth. Obstet Gynecol 2010;116:254–60. https://doi.org/10.1097/aog.0b013e3181e7d975. - PubMed
  11. World Health Organization. The WHO application of ICD-10 to deaths during the perinatal period: ICD-PM. Geneva, Switzerland: World Health Organization; 2016. - PubMed
  12. Heazell, AEP, Siassakos, D, Blencowe, H, Burden, C, Bhutta, ZA, Cacciatore, J, et al.. Stillbirths: economic and psychosocial consequences. Lancet 2016;387:604–16. https://doi.org/10.1016/s0140-6736(15)00836-3. - PubMed
  13. Badillo-López, C, González-Mejía, A, Helguera-Repetto, AC, Salas-Rangel, LP, Rivera-Gutiérrez, S, Cerna-Cortés, JF, et al.. Differential expression of dnaA and dosR genes among members of the Mycobacterium tuberculosis complex under oxic and hypoxic conditions. Int Microbiol 2010;13:9–13. - PubMed
  14. Aminu, M, Unkels, R, Mdegela, M, Utz, B, Adaji, S, ven den Broek, N. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG 2014;121:141–53. https://doi.org/10.1111/1471-0528.12995. - PubMed
  15. Copper, RL, Goldenberg, RL, DuBard, MB, Davis, RO. Risk factors for fetal death in white, black, and Hispanic women. Collaborative group on preterm birth prevention. Obstet Gynecol 1994;84:490–5. - PubMed
  16. McClure, EM, Garces, A, Saleem, S, Moore, JL, Bose, CL, Esamai, F, et al.. Global network for women’s and children’s health research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system. BJOG 2018;125:131–8. https://doi.org/10.1111/1471-0528.14493. - PubMed
  17. Goldenberg, RL, McClure, EM, Saleem, S, Reddy, UM. Infection-related stillbirths. Lancet 2010;375:1482–90. https://doi.org/10.1016/s0140-6736(09)61712-8. - PubMed
  18. Goldenberg, RL, Harrison, MS, McClure, EM. Stillbirths: the hidden birth asphyxia – US and global perspectives. Clin Perinatol 2016;43:439–53. https://doi.org/10.1016/j.clp.2016.04.004. - PubMed
  19. ACOG; SMFM. Management of stillbirth: obstetric care consensus no. 10. Obstet Gynecol 2020;135:747–51. https://doi.org/10.1097/AOG.0000000000003720. - PubMed
  20. Page, J, Silver, R. Evaluation of stillbirth. Curr Opin Obstet Gynecol 2018;30:130–5. https://doi.org/10.1097/gco.0000000000000441. - PubMed

Publication Types