{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T03:39:08Z","timestamp":1764905948327,"version":"3.37.3"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n            Objective\u2003We sought to quantify the distribution of stillbirths by gestational age (GA) in a contemporary cohort and to determine identifiable risk factors associated with stillbirth prior to 32 weeks of gestation.<\/jats:p><jats:p>\n            Study Design\u2003Population-based case-control study of all stillbirths in the United States during the year 2014, utilizing vital statistics data, obtained from the National Center for Health Statistics. Distribution of stillbirths were stratified by 20 to 44 weeks of GA, in women diagnosed with stillbirth in the antepartum period. Pregnancy characteristics were compared between those diagnosed with stillbirth &lt;32 versus \u226532 weeks of gestation. Multivariate logistic regression estimated the relative influence of various factors on the outcome of stillbirth prior to 32 weeks of gestation.<\/jats:p><jats:p>\n            Results\u2003There were 15,998 nonlaboring women diagnosed with stillbirth during 2014 in the United States between 20 and 44 weeks. Of them, 60.1% (n\u2009=\u20099,618) occurred before antenatal fetal surveillance (ANFS) is typically initiated (&lt;32 weeks) and 39.9% (n\u2009=\u20096,380) were diagnosed at \u226532 weeks. Women with stillbirth prior to 32 weeks were more likely to be of non-Hispanic Black race (29.0 vs. 23.9%, p\u2009&lt;\u20090.001), nulliparous (53.8 vs. 50.6%, p\u2009=\u20090.001), have chronic hypertension (CHTN; 6.0 vs. 4.3%, p\u2009&lt;\u20090.001), and fetal growth restriction as evidenced by small for GA (SGA\u2009&lt;\u200910th%) birth weight (44.8 vs. 42.1%, p\u2009&lt;\u20090.001) as opposed to women with stillbirth after 32 weeks. After adjustment, SGA birth weight (adjusted odds ratio [aOR]\u2009=\u20091.2, 95% confidence interval [CI]: 1.1\u20131.3), Black race (aOR\u2009=\u20091.2, 95% CI: 1.1\u20131.3), and CHTN (aOR\u2009=\u20091.3, 95% CI: 1.1\u20131.5) were associated with stillbirth prior to 32 weeks of gestation as opposed to stillbirth after 32 weeks.<\/jats:p><jats:p>\n            Conclusion\u2003More than 6 out of 10 stillbirths in this study occurred &lt;32 weeks of gestation, before ANFS is typically initiated under American College of Obstetricians and Gynecologists recommendations. Among identifiable risk factors, CHTN, Black race, and fetal growth restriction were associated with higher risk of stillbirth before 32 weeks of gestation. Earlier ANFS may be warranted at in certain \u201cat risk\u201d women.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1714421","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T23:24:13Z","timestamp":1596237853000},"page":"084-091","source":"Crossref","is-referenced-by-count":7,"title":["Factors Associated with Occurrence of Stillbirth before 32 Weeks of Gestation in a Contemporary Cohort"],"prefix":"10.1055","volume":"39","author":[{"given":"Elizabeth E.","family":"Brackett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9477-8619","authenticated-orcid":false,"given":"Eric S.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"},{"name":"Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily A.","family":"DeFranco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio"},{"name":"Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1097\/AOG.0b013e31819e9ee2","article-title":"ACOG practice bulletin no. 102. 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An analysis of false-negative fetal deaths","volume":"157","author":"F A Manning","year":"1987","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.ajog.2012.01.022","article-title":"Doppler assessment of the fetus with intrauterine growth restriction","volume":"206","author":"E Berkley","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"ref18","first-page":"CD007529","article-title":"Fetal and umbilical Doppler ultrasound in high-risk pregnancies","volume":"6","author":"Z Alfirevic","year":"2017","journal-title":"Cochrane Database Syst Rev"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1714421.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T23:48:45Z","timestamp":1640821725000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1714421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,31]]},"references-count":17,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2021,12,29]]},"published-print":{"date-parts":[[2022,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1714421","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published":{"date-parts":[[2020,7,31]]}}}