Causes of antepartum stillbirth in women of advanced maternal age.

Objective: To breakdown the causes of antepartum stillbirth by maternal age.

Methods: Observational study. Methods: UK. Methods: Anonymised national data on 2850 cases of antepartum stillbirth in 2009. Methods: The association between cause of stillbirth and maternal age was examined using an adjusted multinomial logistic regression model. Risk ratios were calculated relative to stillbirth due to haemorrhage. Methods: Antepartum stillbirths classified by the Centre for Maternal and Child Enquiries (CMACE) classification.

Results: Stillbirths in women aged 35 years and over are more likely to be due to major congenital anomalies (relative risk ratio (RRR) 2.0, 95% CI 1.3-3.0), mechanical causes (RRR 1.6, 95% CI 1.0-2.6), maternal disorders (RRR 2.1, 95% CI 1.2-3.6) or associated obstetric factors (RRR 2.1, 95% CI 1.1-3.9) than women less than 35. Women aged 35 years and over have a statistically significant increased risk of stillbirth due to major congenital anomalies (OR relative to live birth 1.6, 95% CI 1.3-1.9) and maternal disorders (OR 1.7, 95% CI 1.2-2.4) than younger women. Women aged 35 years and over were 30% more likely to experience a term stillbirth than women <35 years (OR 1.3, 95% CI 1.1-1.5). Stillbirth due to congenital anomaly was statistically significantly more likely in women ≥ 35 years.

Conclusions: Advanced maternal age is a significant risk factor for antepartum stillbirth particularly at term. Attention should be given to stillbirth due to mechanical causes, maternal disorders and associated obstetric factors in such women.