open access
Intrauterine deaths — an unsolved problem in Polish perinatology
Affiliations- Clinical Department of Gynecology and Obstetrics, John Paul II Municipal Hospital in Rzeszow, Poland
- Clinical Department of Obstetrics and Perinatology, University Hospital of the CMUJ in Cracow, Poland
- Clinical Department of Reproduction and Perinatal Medicine, Gynecology And Obstetrics Clinical Hospital, Medical University in Poznan, Poland
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education in Warsaw, Poland
- Department of Pregnancy Pathology, Zelazna Medical Center — Specialist Hospital St. Zofia in Warsaw, Poland
- Department of Reproductive Health CMKP in Warsaw, Poland
- Clinical Department of Obstetrics, Perinatology and Gynecology, University Clinical Center, Medical Uniwersity in Warsaw, Poland
- University Center of Women's and Newborn's Health in Warsaw, Poland
- Clinical Department of Gynecology, Obstetrics and Perinatology, Provincial Clinical Hospital No 2 in Rzeszow, Poland
- Clinical Department of Gynecology and Obstetrics, University Hospital them. Fryderyk Chopin in Rzeszow, Poland
- Clinical Department of Gynecology, Obstetrics and Perinatology, Provincial Municipal Hospital in Ruda Slaska, Poland
- Academy of Applied Medical and Social Sciences in Elblag, Poland
- Department of Gynecology and Obstetrics, Medical University in Gdansk, Poland
- Department of Obstetrics and Gynecology, Independent Public Clinical Hospital, No 2, Medical University in Szczecin, Poland
open access
Abstract
Objectives: The Polish criteria for “intrauterine death” include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. Material and methods: An analysis using 142,662 births in the period between 2015–2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. Results: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. Conclusions: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often.
Abstract
Objectives: The Polish criteria for “intrauterine death” include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. Material and methods: An analysis using 142,662 births in the period between 2015–2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. Results: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. Conclusions: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often.
Keywords
stillbirth; intrauterine deaths; newborn deaths
About this articleTitle
Intrauterine deaths — an unsolved problem in Polish perinatology
Journal
Issue
Article type
Research paper
Published online
2023-11-27
Page views
526
Article views/downloads
251
DOI
Pubmed
Keywords
stillbirth
intrauterine deaths
newborn deaths
Authors
Tomasz Gora
Kamila A. Wojtowicz
Maja Drozdzak
Pawel Guzik
Jakub Kornacki
Katarzyna Kosinska-Kaczynska
Anna Kajdy
Stepan Feduniw
Przemyslaw Kosinski
Anna Szczepkowska
Dorota Darmochwal-Kolarz
Pawel Tos
Tomasz Kluz
Anna Zymroz
Magda Rybak-Krzyszkowska
Hubert Huras
Boguslawa Piela
Marzena Malec
Ewa Banas-Fiebrich
Ewa Janowska-Tyc
Katarzyna Stefanska
Malgorzata Swiatkowska-Freund
Agnieszka Mrozinska
Magdalena Bednarek-Jedrzejek
Aleksandra Kukla
Dominika Boboryko
Urszula Warejko
Dorota Sys
Sebastian Kwiatkowski
References (21)- Metz TD, Berry RS, Fretts RC. Reddy UM, Turrentine MA. Obstetric care consensus. Management of stillbirth. Obstet Gynecol. 2020; 125(3): e110–e132.
- WHO Guidance 2021: Maternal and perinatal death and surveillance and response.
- National Center for Health Statistics. Model state vital statistics act and regulations.Atlanta, GA: Centers for Disease Control and Prevention; 1992. https://www.cdc.gov/nchs/data/misc/mvsact92b.pdf (16.09.2019).
- Zaręba-Szczudlik J, Romejko-Wolniewicz E, Malinowska-Polubiec A, et al. Analiza czynników ryzyka zgonów wewnątrzmacicznych płodów. Perinatol Neoanatol Ginekol. 2009; 2(3): 203–207.
- Frøen JF, Friberg IK, Lawn JE, et al. Lancet Ending Preventable Stillbirths Series study group. Stillbirths: progress and unfinished business. Lancet. 2016; 387(10018): 574–586.
- de Bernis L, Kinney MV, Stones W, et al. Lancet Ending Preventable Stillbirths Series study group, Lancet Ending Preventable Stillbirths Series Advisory Group. Stillbirths: ending preventable deaths by 2030. Lancet. 2016; 387(10019): 703–716.
- Lawn JE, Blencowe H, Waiswa P, et al. Lancet Ending Preventable Stillbirths Series study group, Lancet Stillbirth Epidemiology investigator group. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016; 387(10018): 587–603.
- American College of Obstetricians and Gynecologists. COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care?utm_source=higher- (15.09.2022).
- Flenady V, Wojcieszek AM, Middleton P, et al. Lancet Ending Preventable Stillbirths study group, Lancet Stillbirths In High-Income Countries Investigator Group. Stillbirths: recall to action in high-income countries. Lancet. 2016; 387(10019): 691–702.
- WHO. Global Health Obrervatory data repository. Stillbirth rate. Data by WHO region. https://apps.who.int/gho/data/view.main.STILLBIRTHGWHOREGIONv?lang=en (15.09.2022).
- Główny Urząd Statystyczny.Baza Demografia. Wyniki badań bieżących. https://demografia.stat.gov.pl/bazademografia/Tables.aspx (15.09.2022).
- Troszyński M, Maciejewski T, Wilczyńska A, et al. Przyczyny martwych urodzeń i zgonów noworodków w Polsce w latach 2007–2009. Ginekol Pol. 2011; 82: 598–601.
- Główny Urząd Statystyczny 2018. https://stat.gov.pl/obszary-tematyczne/roczniki-statystyczne/roczniki-statystyczne/rocznik-demograficzny-2018,3,12.html# (15.09.2022).
- Xiong T, Mu Yi, Liang J, et al. Hypertensive disorders in pregnancy and stillbirth rates: a facility-based study in China. Bull World Health Organ. 2018; 96(8): 531–539.
- Kumar M, Vajala R, Bhutia P, et al. Factors contributing to late stillbirth among women with pregnancy hypertension in a developing country. Hypertens Pregnancy. 2020; 39(3): 236–242.
- MBRRACE-UK Perinatal Mortality Surveillance Report for births in 2020.
- Gregory ECW, Valenzuela CP, Hoyert DL. Fetal Mortality: United States, 2020; Hyattsville, MD: National Center for Health Statistics. 2022. National Vital Statistics Reports. 2022; 71(4).
- Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA. 2011; 306(22): 2459–2468.
- Hogue CJR, Parker CB, Willinger M, et al. A population-based case-control study of stillbirth: the relationship of significant life events to the racial disparity for African Americans. Am J Epidemiol. 2013; 177(8): 755–767.
- CDC Center for Global Health 2017 Annual Report. https://www.cdc.gov/globalhealth/resources/reports/annual/pdf/CGH_Annual-Report_2017-h.pdf (15.09.2022).
- Khong T, Mooney E, Ariel I, et al. Sampling and definitions of placental lesions: amsterdam placental workshop group consensus statement. Archives Pathology Laboratory Med. 2016; 140(7): 698–713.
