Retrospective analysis of causes and risk factors of stillbirth with autopsy results

Aim: Stillbirth is defined as the birth of a baby with 22 or more weeks of gestation who dies before or during birth. Stillbirth is a global health problem. This study aims to examine the demographic profile of women with stillbirth, to understand the risk factors for stillbirth, and to facilitate the design of a stillbirth prevention strategy by examining the causes of stillbirth as found by the World Health Organization's (WHO) International Classification of Diseases for Perinatal Mortality (ICD-PM) trying to prevent stillbirths. It is aimed to take the necessary precautions by predicting the negative situations that may occur in the next pregnancies in women with a history of stillbirth, to ensure a healthy continuation of the pregnancy, and to contribute to the realization of a healthy birth on time. Material and Methods: We conducted a retrospective cross-sectional study by examining a total of 499 stillbirth cases that met the acceptance criteria within the borders of Antalya province between 2018 and 2021, which were reported to the Antalya Provincial Health Directorate. Results: In our study, unexplained cases with a rate of 37% took first place in the etiology of stillbirth. In the etiology of stillbirth, fetal hypoxia (18%) was the second most common, ablation placenta (8.3%) was the third most common cause, and the fourth most common reason was the complication of labor and delivery with fetal distress with a rate of 6.8%. Complications of the placental cord and membranes accounted for 22.6%, antepartum hypoxia 11.2%, fetal congenital abnormalities 8.6%, fetal growth restriction 7.2%, and infection 1% among stillbirth causes. In our study, the mean weight of dead babies was found to be 1735 g, and the mean gestational week was evaluated as 32 weeks. It was found that fetal autopsy was performed only in 2% of the cases. As a result of the follow-up, it was determined that 12.8% of the mothers had medical problems. It was observed that 3.1% of these problems were anemia, 40.6% hipertansiyon, 20.3% diabetes, 10.9% proteinuria, and 25% other disorders. It was determined that 9.4% of the mothers had substance addiction. It was determined that 2.1% of the mothers with substance addiction had alcohol and other addictions and 95.7% of them were cigarette addictions. When we divided the causes of stillbirth into groups, it was seen that different risk factors came to the fore. Conclusion: One of the biggest challenges in preventing stillbirths is the lack of knowledge about their causes. The results of this study may contribute to the orientation towards primary preventive health programs that include antenatal care. The stillbirth rate can be reduced by increasing antenatal care services in primary and secondary centers, identifying high-risk pregnancies in earlier weeks of gestation, and taking necessary medical precautions. Key Words: Stillbirth, Risk Factors for Stillbirth, Causes of Stillbirth, Prevention Strategies