Stillbirth and subsequent pregnancy outcome – a cohort from a large tertiary referral hospital

Maria Pekkola; Minna Tikkanen; Mika Gissler; Jorma Paavonen; Vedran Stefanovic

doi:10.1515/jpm-2019-0425

Article

Stillbirth and subsequent pregnancy outcome – a cohort from a large tertiary referral hospital

Maria Pekkola , Minna Tikkanen , Mika Gissler , Jorma Paavonen and Vedran Stefanovic

Published/Copyright: January 11, 2020

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From the journal Journal of Perinatal Medicine Volume 48 Issue 8

Abstract

Objectives

This study aimed to assess pregnancy and delivery outcomes in women with a history of stillbirth in a large tertiary referral hospital.

Methods

This was a retrospective study from Helsinki University Hospital, Finland. The cohort comprised 214 antepartum singleton stillbirths in the period 2003–2015 (case group). Of these, 154 delivered by the end of 2017. Adverse pregnancy outcomes were compared to those in singleton pregnancies of parous women in Finland from the Finnish Medical Birth Register (reference group).

Results

The rates of adverse pregnancy outcomes were higher among case women for preeclampsia (3.3 vs. 0.9%, P = 0.002), preterm birth (8.5 vs. 3.9%, P = 0.004), small-for-gestational-age (SGA) children (7.8 vs. 2.2%, P < 0.001) and stillbirth (2.7 vs. 0.3%, P < 0.001). There were four preterm recurrent stillbirths. Induction of labor was more common among case women than parous women in the reference group (49.4 vs. 18.3%, P < 0.001). Duration of pregnancy was shorter among case women (38.29 ± 3.20 vs. 39.27 ± 2.52, P < 0.001), and mean birth weight was lower among newborns of the case women (3274 ± 770 vs. 3491 ± 674 g, P < 0.001).

Conclusion

Although the rates for adverse pregnancy outcomes were higher compared to the parous background population, the overall probability of a favorable outcome was high. The risk of recurrent premature stillbirth in our cohort was higher than that for parous women in general during the study period. No recurrent term stillbirths occurred, however.

Keywords: counseling; pregnancy outcome; stillbirth

Corresponding author: Prof. Vedran Stefanovic, MD, PhD, Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00029 Helsinki, Finland, Phone: +358 50 427 1230

Acknowledgments

We thank Carolyn Brimley Norris, PhD for participation in language editing.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This study was funded by Helsinki University research grants TYH2017240 and Y1017N0183 and Helsinki University Hospital Institute (3816 IAI 500110).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2019-11-16

Accepted: 2019-12-10

Published Online: 2020-01-11

Published in Print: 2020-10-25

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Articles in the same Issue

https://doi.org/10.1515/jpm-2019-0425

Keywords for this article

counseling; pregnancy outcome; stillbirth