What constitutes the low perinatal mortality in Hong Kong: a 20-year review from a public obstetric unit (Part 1: Stillbirth in singleton pregnancies)
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AbstractIntroduction: To investigate the underlying causes of singleton stillbirths over the past 2 decades in Hong Kong.
Method: It is retrospective study of the prevalence and cause of stillbirths in a university tertiary obstetric unit between 2000 and 2019. Medical records were reviewed for all singleton pregnancies complicated by stillbirths. The causes of stillbirth were concluded based on the combination of clinical assessment and laboratory results, and compared between the first and the second decades.
Results: The overall perinatal mortality rate was significantly reduced by 16.7%, from 5.52/1000 in the first decade to 4.60/1000 in the second, though the trends in singleton stillbirth rate could not reach a statistical significant level (3.28/1000 to 2.91/1000). This is mainly because of improvement in early prenatal diagnosis of congenital malformations and genetic disorders. The prevalence of pre-eclampsia among singleton pregnancies has been rising from 1.51% to 1.65% due to the increasing maternal age, but the stillbirth rate per pre-eclamptic patients has dropped from 2.5% to 1.4%. FGR of unknown cause contribute to 16% of all stillbirth, and its prevalence has not changed with time. Of these FGR 43.5% were not diagnosed during routine antenatal care. Unexplained stillbirths contributed 36% of all stillbirths. The prevalence of stillbirth associated with chorioamnionitis and placental abruption remained similar throughout the two decades.
Conclusions: The causes of stillbirth have changed in the past two decades owing to change in demographic characteristics and advancement in prenatal testing. Further improvement should focus on early detection of FGR and prevention of pre-eclampsia.
Acceptance Date13/04/2021
All Author(s) ListWong Sani Tsz Kei, Tse Wing Ting, Lau So Ling, Sahota Daljit Singh, Leung Tak Yeung
Journal nameHong Kong Medical Journal
Year2021
ISSN1024-2708
LanguagesEnglish-United Kingdom

Last updated on 2021-14-05 at 11:21