Dødfødsler i Akershus 1993-2002

Abstract

Background:

There were 61074 deliveries in Akershus county, Norway (1993-2002). The perinatal audit investigated 221 antepartum, 19 intrapartum and 113 neonatal deaths.

Objective:

The purpose of this study was to find out whether the perinatal mortality rate is comparable to the rest of the country. We categorized the cause of death and studied the ability to detect pregnancies with higher risk for perinatal death with focus on IUGR in Akershus.

Methods:

Retrospective study of the stillbirth cases investigated by the perinatal audit. The information was gathered by the Perinatal Committee of Akershus, and supplemented by antenatal health cards and maternal health records.

Results:

The perinatal death rate in Akershus was 5.8/1000. The stillbirth rate (gestational age 28 and more) was 3.4/1000 and neonatal mortality rate was 2.4/1000. Unexplained stillbirth was diagnosed in 22 % of antepartum deaths, placental insufficiency 19 %, abruption of the placenta 15 %, infections 10 %, not known 9 %, umbilical cord pathology 7 % and malformations in 5 %.

IUGR was recognized by antenatal care as a pregnancy complication in 17 % of the stillbirth. By using individually customized standards, 43% of stillbirths were below the 2.5th birth weight centile for their gestational age. 56 % were below the 10th centile. The specificity was good, when prospectively recognized IUGR 92 % had birth weight under the 2.5th centile.

Conclusion:

The stillbirth rate in Akeshus was equal to the national rate (3.5/1000) in this period. 31% of deaths had no explanation. 56 % were below the 10th birth weight centile, but only 17 % were recognized by antenatal care. Akershus has a great potential in detection of causes of death and IUGR