{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:38:12Z","timestamp":1789504692436,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Understanding the local characteristics and statistics related to stillbirths may be the first step in a series of strategies associated with a reduction in stillbirth ratio. The aim of this study was to estimate the fetal mortality ratio and evaluate the investigation processes related to the causes of death, comparing the investigation according to the specific cause of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was retrospectively conducted in 10 tertiary obstetric care centers. Medical records of women with stillbirth managed between January 1, 2009 and December 31, 2018 were analyzed and classified, according to sociodemographic characteristics, and gestational and childbirth data, culminating in stillbirth. The stillbirth ratio and its causes were presented in proportions for the study period and individually for each health facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cases of 3390 stillbirths were analyzed. The stillbirth ratio varied from 10.74\/1000 live births (LBs) in 2009 to 9.31\/1000 in 2018. \u201cIntrauterine hypoxia and asphyxia\u201d (ICD\u201010 P20) and \u201cunspecific causes of death\u201d (ICD\u201010 P95) represented 40.8% of the causes of death. Investigation for TORCHS and diabetes occurred in 90.8% and 61.4% of deaths, respectively. Placental and necroscopic tests were performed in 36.6% of the cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The adoption of a rational and standardized investigation of stillbirth remains an unmet need; the use of additional tests and examinations are lacking, especially when unspecific causes are attributed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15839","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T11:42:22Z","timestamp":1722512542000},"page":"220-229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Causes and investigation of stillbirths in Brazil: A multicentre cross\u2010sectional study in 10 referral maternity hospitals"],"prefix":"10.1002","volume":"168","author":[{"given":"Mariana","family":"Brasileiro","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Campinas (UNICAMP), School of Medical Sciences  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherly","family":"Metelus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Campinas (UNICAMP), School of Medical Sciences  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thayna B.","family":"Griggio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Campinas (UNICAMP), School of Medical Sciences  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matias C.","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Campinas (UNICAMP), School of Medical Sciences  Campinas Brazil"},{"name":"Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London Women's Health Academic Centre KHP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos A. 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