Causes of stillbirths among women from South Africa: a prospective, observational study

Publication date: April 2019Source: The Lancet Global Health, Volume 7, Issue 4Author(s): Shabir A Madhi, Carmen Briner, Salome Maswime, Simpiwe Mose, Philiswa Mlandu, Richard Chawana, Jeannette Wadula, Yasmin Adam, Alane Izu, Clare L CutlandSummaryBackgroundAbout 2·6 million third-trimester stillbirths occur annually worldwide, mostly in low-income and middle-income countries, where the causes of these deaths are rarely investigated.MethodsWe did a prospective, hospital-based, observational study in Soweto, South Africa, to investigate the causes of stillbirths in fetuses of at least 22 weeks' gestational age or with a birthweight of at least 500 g. Maternal clinical information was abstracted from medical records. Investigations included placental macroscopic and histopathological examination and fetal blood culture (including screening for pathogenic bacteria associated with stillbirth). Cases missing one or more of these investigations were considered to have incomplete samples and were excluded from the analysis of cause of stillbirth. Causes of stillbirths were assessed by individual case reviews by at least two obstetricians, and classified with a modified Stillbirth Collaborative Research Network classification system.FindingsBetween Oct 9, 2014, and Nov 8, 2015, we enrolled 354 stillbirths (born to 350 women). Among the women with available data, 133 (38%) of 350 had hypertension, median age was 27 years (IQR 23–33), 51 (18%) of 291 were obese, six (2%) of 344 had...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research