Objective: To analyze a cohort of clinically unexplained stillbirths (CUS) referred for postmortem.
Study design: In total, 258 CUS were referred for full postmortem between 2009 and 2015. Relevant Condition at Death (ReCoDe) classification was applied. Statistical analysis included chi-square test and multiple logistic regression.
Results: In all, 386 ReCoDe categories identified corresponded to: fetus (99); umbilical cord (48); placenta (165); amniotic fluid (55), and mother (1). No condition was identified in 18 cases. Prevalent conditions were placental insufficiency (101 cases, 39%) and fetal growth restriction (96 cases, 37%), frequently presenting together (41 cases, 15.9%). Significant associations were found between fetal growth restriction and gestational age, asymmetrical fetal growth and placental insufficiency.
Conclusions: In total, 60.5% of CUS were diagnosed at postmortem to have fetal growth restriction and/or placental insufficiency. The mean gestational age of death in which these conditions presented was 32.7 weeks and 35.5 weeks, respectively, suggesting a critical time-frame to monitor to potentially reduce stillbirth occurrence.