Epidemiology of Unexplained Antepartum Fetal Death in Australia

婴儿出生前死亡对父母和家庭来说是一个毁灭性的事件。在这些死亡中，没有找到任何原因，没有给父母和护理人员留下任何线索，他们正在努力决定未来的怀孕以及如何降低所有怀孕妇女的风险。在分娩前无明显原因的胎儿死亡（不明原因的产前胎儿死亡（UAFD））是胎儿死亡的最常见原因。在澳大利亚，UAFD的比率约为每1 000例分娩中有2例，占所有胎儿死亡的30%。在澳大利亚，UAFD的发病率是目前婴儿猝死综合症（SIDS）发病率的三倍多。尽管如此，这方面的研究还很少。已经进行的研究表明，怀孕期间存在的因素可能会确定哪些妇女处于危险之中。然而，这些研究的结果并不一致，主要是由于研究设计的问题，因此现有的信息不够可靠，无法帮助确定处于危险中的妇女。迫切需要进行精心设计的大规模研究，以便从所报告的风险因素清单中确定哪些因素能够真正确定妇女在产前面临的风险增加，从而可以提供适当的护理以减少胎儿死亡的可能性。最近，一项涉及澳大利亚临床医生和消费者的合作努力已经开始，以支持和进行研究和相关活动，并与国际团体合作，以减少UAFD的风险（澳新银行胎儿死亡合作小组）。这项研究构成了澳大利亚境内这项工作的基础。本研究旨在确定有不明原因产前胎儿死亡风险的妇女。这项研究涉及对澳大利亚三个州的800例不明原因的产前胎儿死亡进行审查，并对澳大利亚卫生部门例行收集的所有出生信息进行分析。

The death of a baby before birth is a devastating event for the parents and families. In the vast number of these deaths, no cause can be found leaving no clues for parents and care providers struggling with decisions about future pregnancies and how the risk may be reduced for all women in pregnancy. Fetal death before the onset of labour without an apparent cause (Unexplained Antepartum Fetal Death (UAFD) constitutes the most common cause of fetal death. In Australia, the rate of UAFD is approximately 2 per 1 000 births, contributing 30% to all fetal deaths. The rate of UAFD is over three times the current rate of Sudden Infant Death Syndrome (SIDS) in Australia. Despite this, little research has been undertaken in this area. The research which has been undertaken suggests that factors which are present during pregnancy may identify women who are at risk. However, the results of these studies are not consistent, largely due to the problems with study design, and therefore the available information is not sufficiently reliable to assist in identification of women at risk. Well designed, large scale studies are urgently needed to determine, from the reported list of risk factors, those factors which truly identify a woman at increased risk in the antenatal period where appropriate care can be provided to decrease the likelihood of fetal death. Recently, a collaborative effort involving clinicians and consumers in Australia has commenced to support and undertake research and related activities and to collaborate with international groups in reducing the risk of UAFD (ANZ Fetal Death Collaborative Group). This study forms the basis for this work within Australia. This study is designed to identify women who are at risk of unexplained antepartum fetal death. The study involves a review of 800 unexplained antepartum fetal deaths in three States of Australia and an analysis of information on all births in Australia which is routinely collected by Health Departments.