Determinant Factors of Unexplained Ante partum Stillbirths

Advances in health and medical technology which anticipate, closely monitor and treat pregnant women have reduced the number of explained ante partum stillbirths and reduced the overall stillbirth rate. However, unexplained ante partum stillbirth has been proportionally increasing in both developed and developing countries. Few studies have attempted to assess determinant factors related to unexplained ante partum stillbirth. No clear guidelines have been drawn up to screen those who are at risk for unexplained ante partum stillbirth. This thesis aims to identify possible determininant factors for unexplained ante partum stillbirth. A structured review of studies on unexplained ante partum stillbirths was conducted to identify the determinant factors. A review of stillbirth risk factor in Malaysia was carned out based on published papers. To obtain new information on this topic population study using 10 years of Scottish data has been conducted. The outcome of the structured review, Scottish study and Malaysian review showed that extreme maternal age and increasing gestational age significantly increase the risk of having unexplained ante partum stillbirths. Smoking and a previous history ofstillbirth were additional risk indicators that could be identified during the antenatal period. Nullipara and a parity of more than 3 also contribute to the risk ofunexplained ante partum stillbirth. Maternal obesity was shown in the structured review to be consistent in all studies in increasing the risk, but the risk of obesity could not be assessed for either the Malaysian or Scottish studies. Identification of these risk factors and the ability to monitor them closely may help reduce the number of stillbirths classified as unexplained.