{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:24:11Z","timestamp":1783736651274,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The majority of perinatal deaths occur in the preterm period; however, current approaches predominantly focus on prevention in the term period. Reducing perinatal deaths in the preterm period is, therefore, key to reducing the rates of perinatal death overall in Australia. The aim was to understand the classifications of causes of preterm stillbirth and neonatal death in Victoria over time and by gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Retrospective study using state\u2010wide, publicly available data. All births in Victoria between 2010 and 2018 included in the Victorian Perinatal Data Collection, excluding terminations of pregnancy for maternal psychosocial indications, were studied. Differences in causes of preterm perinatal mortality gestation group and over time were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 7977 perinatal deaths reported, 85.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a06849) were in the preterm period. The most common cause of preterm stillbirths was congenital anomalies (<jats:italic>n<\/jats:italic>\u00a0=\u00a01574, 29.8%), followed by unexplained antepartum deaths (<jats:italic>n<\/jats:italic>\u00a0=\u00a0557, 14.2%). The most common cause of preterm neonatal death was spontaneous preterm birth (sPTB; <jats:italic>n<\/jats:italic>\u00a0=\u00a0599, 38.2%), followed by congenital anomalies (<jats:italic>n<\/jats:italic>\u00a0=\u00a0493, 31.4%). The rate of preterm stillbirths due to hypertension (\u221214.9% (95% CI \u221227.1% to \u22122.7%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02)), maternal conditions (\u221224.1% (95% CI \u221244.2% to \u22124.0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03)) and those that were unexplained (\u22125.4% (95% CI \u22129.8% to \u22121.2%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02)) decreased per annum between 2010 and 2018. All other classifications did not change significantly over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prevention of congenital anomalies and sPTB is critical to reducing preterm perinatal mortality. Greater emphasis on understanding causes of preterm deaths through mortality investigations may reduce the proportion of those considered \u2018unexplained\u2019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13497","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T12:02:06Z","timestamp":1646308926000},"page":"511-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Causes of perinatal deaths in Australia: Slow progress in the preterm period"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-472X","authenticated-orcid":false,"given":"Kirstin","family":"Tindal","sequence":"first","affiliation":[{"name":"The Ritchie Centre Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4675-1788","authenticated-orcid":false,"given":"Gayathri","family":"Bimal","sequence":"additional","affiliation":[{"name":"Monash University Obstetrics and Gynaecology  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8114-7677","authenticated-orcid":false,"given":"Vicki","family":"Flenady","sequence":"additional","affiliation":[{"name":"Mater Research Institute University of Queensland  Brisbane Queensland Australia"},{"name":"NHMRC Centre for Research Excellence in Stillbirth  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-1066","authenticated-orcid":false,"given":"Adrienne","family":"Gordon","sequence":"additional","affiliation":[{"name":"University of Sydney  Sydney New South Wale Australia"},{"name":"NHMRC Centre for Research Excellence in Stillbirth  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Farrell","sequence":"additional","affiliation":[{"name":"Safer Care Victoria  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1918-5538","authenticated-orcid":false,"given":"Miranda","family":"Davies\u2010Tuck","sequence":"additional","affiliation":[{"name":"The Ritchie Centre Hudson Institute of Medical Research  Melbourne Victoria Australia"},{"name":"NHMRC Centre for Research Excellence in Stillbirth  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"The Senate.Select Committtee on Stillbirth Research and Education. Canberra (AU) 2018."},{"key":"e_1_2_6_3_1","unstructured":"PriceWaterhouseCooper.The economic impacts of stillbirth in Australia.2016."},{"key":"e_1_2_6_4_1","unstructured":"The NHMRC Centre for Research Excellence in Stillbirth.The Safer Baby Bundle.2019."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12508"},{"key":"e_1_2_6_6_1","volume-title":"Australia\u2019s Mothers and Babies 2018","year":"2020"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-10-S1-S1"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.10.864"},{"key":"e_1_2_6_9_1","volume-title":"PSANZ Care around the time of stillbirth and neonatal death guidelines group. Clinical Practice Guideline for Care Around Stillbirth and Neonatal Death","author":"Flenady V","year":"2020"},{"issue":"4","key":"e_1_2_6_10_1","first-page":"CD012504","article-title":"Interventions for investigating and identifying the causes of stillbirth","volume":"4","author":"Wojcieszek AM","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_11_1","volume-title":"Clinical Practice Guideline for Care around Stillbirth and Neonatal Death","author":"Flenady VOJ","year":"2020"},{"key":"e_1_2_6_12_1","volume-title":"Australia\u2019s Mothers and Babies 2017\u2010in brief","author":"Australian Institute of Health and Welfare","year":"2019"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16665"},{"key":"e_1_2_6_14_1","unstructured":"Better Safer Care.Consultative council on obstetric and paediatric mortality and morbidity.https:\/\/www.bettersafercare.vic.gov.au\/about\u2010us\/ccopmm. Published2020. Accessed 4th Jan 2020."},{"key":"e_1_2_6_15_1","volume-title":"Victorian Perinatal Data Collection","author":"Department of Health and Human Services","year":"2020"},{"key":"e_1_2_6_16_1","first-page":"151","volume-title":"International Statistical Classification of Diseases and Related Health Problems 10th Revision","author":"World Health Organization","year":"2011"},{"key":"e_1_2_6_17_1","unstructured":"Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM).Congenital anomalies in Victoria 2015\u20132016. 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