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件毁灭性的事件。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，他们正在为未来怀孕的决定以及如何降低所有怀孕女性的风险而苦苦挣扎。无明显原因的分娩前胎儿死亡(原因不明的产前胎儿死亡是胎儿死亡的最常见原因)。在澳大利亚，UAFD的发病率约为每1000名新生儿中有2名，占所有胎儿死亡的30%。UAFD的发病率是澳大利亚目前婴儿猝死综合症(SID)发病率的三倍多。尽管如此，这一领域的研究却很少。已经进行的这项研究表明，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，这主要是由于研究设计的问题，因此现有的信息不够可靠，不足以帮助识别处于危险中的妇女。迫切需要进行精心设计的大规模研究，以便从报告的风险因素清单中确定哪些因素能够真正确定产前风险增加的妇女，从而提供适当的护理以降低胎儿死亡的可能性。最近，澳大利亚临床医生和消费者参与的合作努力已经开始，以支持和开展研究和相关活动，并与国际组织合作，降低UAFD(ANZ胎儿死亡合作小组)的风险。这项研究构成了澳大利亚国内这项工作的基础。这项研究旨在确定有不明原因的产前胎儿死亡风险的女性。这项研究涉及对澳大利亚三个州800例不明原因的产前死亡的审查，以及对卫生部门例行收集的澳大利亚所有出生的信息的分析。

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.