Stillbirth - A Silence that should be broken Flashcards
What are the risk factors of stillbirth in high income countries?
Overweight/obesity Advanced maternal age Smoking Preexisting hypertension/diabetes More at risk in first pregnancy Ethnicity - Southern Asia (Bangladesh, India)
Define stillbirth
The birth of an infant that has died in the womb. More than 20 weeks gestation or >400g
Why is late gestation stillbirth used in international data comparisons?
In many countries with poor healthcare infrastructure there is limited data on early gestation stillbirth so >28weeks is often used to make international comparisons.
What can stillbirth rates illustrate about a country?
Still birth rates associated with newborn death rate and maternal mortality rate.
A reflection of the healthcare system of a country.
Why has stillbirths only recently been in the spotlight of global health when the number of stillbirths in a year is the same number as all babies born in Western Europe?
Didn’t know these babies existed, no comprehensive data.
Where does Australia sit on rankings of stillbirth?
Australia is low on the top 12 high income countries. However could prevent 200 stillbirth if our rates were as low as Finland, Sweden etc.
What is the effect of stillbirth on families and society?
Significant bereavement, as stressful as losing an infant.
Less likely to return to work, decreased earnings.
Marriage breakdown
Stigma, abandonment, abuse
What re the major causes of stillbirths?
Congenital abnormality
Maternal conditions
Spontaneous preterm birth
Unexplained antepartum death (more common in near term stillbirths)
Outline ethnicity as a risk factor of stillbirth.
Southern Asia mothers have greater likelihood to stillbirths.
What is the relationship between obesity and stillbirth?
Risk of stillbirth increases with each class of BMI. However BMI > 50 have exponential risk, especially at 40-42 weeks.
What is the relationship between weight gain between pregnancies and stillbirth?
Even in women with normal BMI, if they gain 2 BMI units between pregnancies, risk of stillbirth will increase.
Even more so for women with high BMI.
If lose weight between pregnancies, risk will decrease.
What are the benefits of the gestational weight gain guidelines according to each BMI range?
Reduced caesarean sections
Reduced pregnancy related hypertension
No increase in low birth weight infants
What are some considerations for best practice in obesity and stillbirth?
Is it safe for overweight women to implement preventative strategies during pregnancy, what is the effect on the baby?
Should overweight women be offered induction at term?
What effect do differing metabolic environments have on the developing foetus?
What is the relationship between maternal age and stillbirth?
Increase risk of still birth in older women, especially at late gestation.
What are the effects of induction of labour at term in older mothers?
No difference in risk of adverse outcomes when induction is applied vs. no induction.
