Ethnic variation in stillbirth risk and the role of maternal obesity: analysis of routine data from a London maternity unit


Penn, N; Oteng-Ntim, E; Oakley, LL; Doyle, P; (2014) Ethnic variation in stillbirth risk and the role of maternal obesity: analysis of routine data from a London maternity unit. Bmc Pregnancy and Childbirth, 14. p. 404. ISSN 1471-2393 DOI: https://doi.org/10.1186/s12884-014-0404-0

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Abstract

BackgroundApproximately 5 in 1,000 deliveries in England and Wales result in stillbirth, with little improvement in figures over the last few decades. The aim of this study was to investigate the association between clinical and socio-demographic factors and stillbirth, with a particular focus on ethnicity and obesity.MethodsAnalysis of routine maternity data on 53,293 singleton births occurring in a large London teaching hospital between 2004 and 2012. Logistic regression was used to investigate risk factors for stillbirth and to explore potential effect modification.Results53,293 deliveries occurred during the time period, of which 329 resulted in a stillbirth (6.2 per 1,000 births). Compared to White women, non-White ethnicity was associated with a doubling of the odds of stillbirth (aOR for Black women 2.15, 95% CI 1.56-2.97; aOR for South Asian women 2.33, 95% CI 1.42-3.83). Obese women had a trend towards higher odds of stillbirth compared to women of recommended BMI (aOR 1.38, 95% CI 0.98-1.96), though this was not significant (p 0.07). Both higher parity (¿2 compared to para 1) and hypertension were associated with a higher odds of stillbirth (parity ¿2 aOR 1.65, 95% CI 1.13-2.39; hypertension aOR 1.84, 95% CI 1.22-2.78) but there was no evidence that area deprivation or maternal age were independently associated with stillbirth in this population. There was some evidence of effect modification between ethnicity and obesity (p value for interaction 0.06), with obesity a particularly strong risk factor for stillbirth in South Asian women (aOR 4.64, 95% CI 1.84-11.70).ConclusionsThere was a high prevalence of stillbirth in this multi-ethnic urban population. The increased risk of stillbirth observed in non-White women remains after adjusting for other factors. Our finding of possible effect modification between ethnicity and obesity suggests that further research should be conducted in order to improve understanding of the interplay between ethnicity, obesity and stillbirth.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 25481783
Web of Science ID: 346750600001
URI: http://researchonline.lshtm.ac.uk/id/eprint/2124218

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