{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T11:55:50Z","timestamp":1775390150662,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the relationship between the English index of multiple deprivation (IMD) and the incidence of stillbirth and assess whether IMD contributes to the prediction of stillbirth provided by the combination of maternal demographic characteristics and elements of medical history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, observational study of 159\u2009125 women with a singleton pregnancy who attended their first routine hospital visit at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation in two maternity hospitals in the UK. The inclusion criterion was delivery at \u2265\u200924\u2009weeks' gestation of a fetus without major abnormality. Participants completed a questionnaire on demographic characteristics and obstetric and medical history. IMD was used as a measure of socioeconomic status, which takes into account income, employment, education, skills and training, health and disability, crime, barriers to housing and services, and living environment. Each neighborhood is ranked according to its level of deprivation relative to that of other areas into one of five equal groups, with Quintile\u20091 containing the 20% most deprived areas and Quintile\u20095 containing the 20% least deprived areas. Logistic regression analysis was used to determine whether IMD provided a significant independent contribution to stillbirth after adjustment for known maternal risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall incidence of stillbirth was 0.35% (551\/159\u2009125), and this was significantly higher in the most deprived compared with the least deprived group (Quintile\u20091 <jats:italic>vs<\/jats:italic> Quintile\u20095). The odds ratio (OR) in Quintile\u20091 was 1.57 (95%\u2009CI, 1.16\u20132.14) for any stillbirth, 1.64 (95%\u2009CI, 1.20\u20132.28) for antenatal stillbirth and 1.89 (95%\u2009CI, 1.23\u20132.98) for placental dysfunction\u2010related stillbirth. In Quintile\u20091 (<jats:italic>vs<\/jats:italic> Quintile\u20095), there was a higher incidence of factors that contribute to stillbirth, including black race, increased body mass index, smoking, chronic hypertension and previous stillbirth. The OR of black (<jats:italic>vs<\/jats:italic> white) race was 2.58 (95%\u2009CI, 2.14\u20133.10) for any stillbirth, 2.62 (95%\u2009CI, 2.16\u20133.17) for antenatal stillbirth and 3.34 (95%\u2009CI, 2.59\u20134.28) for placental dysfunction\u2010related stillbirth. Multivariate analysis showed that IMD did not have a significant contribution to the prediction of stillbirth provided by maternal race and other maternal risk factors. In contrast, in black (<jats:italic>vs<\/jats:italic> white) women, the risk of any and antenatal stillbirth was 2.4\u2010fold higher and the risk of placental dysfunction\u2010related stillbirth was 2.9\u2010fold higher after adjustment for other maternal risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of stillbirth, particularly placental dysfunction\u2010related stillbirth, is higher in women living in the most deprived areas in South East England. However, in screening for stillbirth, inclusion of IMD does not improve the prediction provided by race, other maternal characteristics and elements of medical history. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26096","type":"journal-article","created":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T17:54:20Z","timestamp":1666547660000},"page":"198-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incidence of stillbirth: effect of deprivation"],"prefix":"10.1002","volume":"61","author":[{"given":"A.","family":"Arechvo","sequence":"first","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"},{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences Lund Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. A.","family":"Nikolaidi","sequence":"additional","affiliation":[{"name":"GKT School of Medical Education King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9993-5249","authenticated-orcid":false,"given":"M. M.","family":"Gil","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"},{"name":"Department of Obstetrics and Gynecology Hospital Universitario de Torrej\u00f3n, Torrej\u00f3n de Ardoz  Madrid Spain"},{"name":"School of Medicine Universidad Francisco de Vitoria (UFV), Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Rolle","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Platform Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias  Oviedo Asturias Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01112-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)92717-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38629.587639.7C"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-22"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17066"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11123452"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12430"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26084"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"e_1_2_7_13_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2022"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22129"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042753"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057412"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckr074"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckq200"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"issue":"199","key":"e_1_2_7_21_1","first-page":"e1","article-title":"Predictive performance of the competing risk model in screening for preeclampsia","volume":"220","author":"Wright D","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.561"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19077"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16815"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24795"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20258"},{"issue":"486","key":"e_1_2_7_28_1","first-page":"e1","article-title":"Prediction of small for gestational age neonates: screening by maternal factors, fetal biometry, and biomarkers at 35\u201337\u2009weeks' gestation","volume":"220","author":"Ciobanu A","year":"2019","journal-title":"Am J Obstet Gynecol"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26096","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.26096","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T15:04:14Z","timestamp":1692457454000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/uog.26096"],"URL":"https:\/\/doi.org\/10.1002\/uog.26096","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]},"assertion":[{"value":"2022-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}