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Fetuses were assessed as small for gestational age (SGA), large for gestational age (LGA), adequate for gestational age (AGA), preterm (PT) as less than 37\u2009weeks of gestation, non\u2010PT (NPT) as 37\u2009weeks of gestation or more, low birth weight (LBW) as less than 2500\u2009g, and non\u2010LBW (NLBW) as 2500\u2009g or more. Relative risks (RR) with robust variance were estimated using Poisson regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all 442\u2009782 pregnancies, including 2321 (0.5%) stillbirths, were included. About 85% (<jats:italic>n<\/jats:italic> = 1983) of stillbirths had at least one characteristic of vulnerability, compared with 21% (<jats:italic>n<\/jats:italic> = 92524) of live births. Fetuses with all three markers of vulnerability had the highest adjusted RR of stillbirth\u2014SGA\u2009+\u2009LBW\u2009+\u2009PT (RR 155.00; 95% confidence interval [CI] 136.29\u2013176.30) and LGA\u2009+\u2009LBW\u2009+\u2009PT (RR 262.04; 95% CI 206.10\u2013333.16) when compared with AGA\u2009+\u2009NLBW\u2009+\u2009NPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings show that the simultaneous presence of prematurity, low birth weight, and abnormal intrauterine growth presented a higher risk of stillbirths. To accelerate progress towards reducing preventable stillbirths, one must identify the circumstances of greatest biologic vulnerability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15102","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T11:34:46Z","timestamp":1694777686000},"page":"442-452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and risk of stillbirth according to biologic vulnerability phenotypes in the municipality of S\u00e3o Paulo, Brazil: A population\u2010based cohort study"],"prefix":"10.1002","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-4995","authenticated-orcid":false,"given":"Lays Janaina Prazeres","family":"Marques","sequence":"first","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4648-113X","authenticated-orcid":false,"given":"Zilda Pereira da","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2354-9050","authenticated-orcid":false,"given":"Gizelton Pereira","family":"Alencar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4797-908X","authenticated-orcid":false,"given":"Enny Santos da","family":"Paix\u00e3o","sequence":"additional","affiliation":[{"name":"Center for Data and Knowledge Integration for Health (CIDACS) Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation  Bahia Salvador Brazil"},{"name":"Infectious Disease Epidemiology, London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-3159","authenticated-orcid":false,"given":"Hannah","family":"Blencowe","sequence":"additional","affiliation":[{"name":"Maternal Adolescent Reproductive &amp; Child Health (MARCH) Centre, London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0052-1888","authenticated-orcid":false,"given":"Marcia Furquim","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01112-0"},{"key":"e_1_2_9_3_1","unstructured":"UNICEF.A neglected tragedy: the global burden of stillbirths. 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