Epidemiology of unexplained stillbirth: antecedents and sequelae

Mary-Anne Measey

Research output: ThesisDoctoral Thesis

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Abstract

[Truncated abstract] The unexpected death of a baby before birth is a devastating event. Despite considerable advances in obstetrics and perinatal medicine, there is no explanation for up to a quarter of these deaths. Known as unexplained stillbirths, they occur without apparent cause. This thesis was undertaken to investigate the epidemiology of unexplained stillbirth. It sought to increase knowledge regarding the aetiology, antecedents and sequelae of unexplained stillbirth to assist efforts in prevention. Central to the conduct of research on unexplained stillbirth is the issue of case ascertainment. The first objective of this thesis was, therefore, to determine the best method of identifying unexplained stillbirths. Their careful and correct ascertainment was integral to this body of research. The uptake of fetal postmortem investigations and their utility for clinically unexplained stillbirths were reviewed. To identify risk factors for unexplained stillbirth, a case-control study was undertaken using data routinely collected at the time of birth. Subsequent objectives involved investigating the risk of complications in other births to women who had an unexplained stillbirth. These objectives were designed to test the hypothesis that other pregnancies to affected women were more likely to have complications linked to poor placentation. Poor placentation has previously been implicated in the aetiology of unexplained stillbirth. A case-control study was undertaken to investigate the fetal growth of infants born of up to four births before an unexplained stillbirth...
Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2011

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