Epidemiology of Unexplained Antepartum Fetal Death in Australia

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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.