Fetal Growth and Risk of Stillbirth: A Population-Based Case–Control Study
Publication Date
April 22, 2014
Journal
PLOS Medicine
Authors
Radek Bukowski, Nellie I. Hansen, Marian Willinger, Uma M. Reddy, et al
Volume
11
Issue
4
Pages
e1001633
DOI
https://dx.plos.org/10.1371/journal.pmed.1001633
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1001633
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/24755550
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995658
Europe PMC
http://europepmc.org/abstract/MED/24755550
Web of Science
000335465800003
Scopus
84900408655
Mendeley
http://www.mendeley.com/research/fetal-growth-risk-stillbirth-populationbased-casecontrol-study
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Mendeley | Further Information

{"title"=>"Fetal Growth and Risk of Stillbirth: A Population-Based Case-Control Study", "type"=>"journal", "authors"=>[{"first_name"=>"Radek", "last_name"=>"Bukowski", "scopus_author_id"=>"7102416022"}, {"first_name"=>"Nellie I.", "last_name"=>"Hansen", "scopus_author_id"=>"7201389849"}, {"first_name"=>"Marian", "last_name"=>"Willinger", "scopus_author_id"=>"57197399772"}, {"first_name"=>"Marian", "last_name"=>"Willinger", "scopus_author_id"=>"7003675832"}, {"first_name"=>"Uma M.", "last_name"=>"Reddy", "scopus_author_id"=>"7005901171"}, {"first_name"=>"Corette B.", "last_name"=>"Parker", "scopus_author_id"=>"36090098600"}, {"first_name"=>"Halit", "last_name"=>"Pinar", "scopus_author_id"=>"7005029281"}, {"first_name"=>"Robert M.", "last_name"=>"Silver", "scopus_author_id"=>"7201936904"}, {"first_name"=>"Donald J.", "last_name"=>"Dudley", "scopus_author_id"=>"35459621900"}, {"first_name"=>"Barbara J.", "last_name"=>"Stoll", "scopus_author_id"=>"56410520600"}, {"first_name"=>"George R.", "last_name"=>"Saade", "scopus_author_id"=>"7006942866"}, {"first_name"=>"Matthew A.", "last_name"=>"Koch", "scopus_author_id"=>"55065479800"}, {"first_name"=>"Carol J.", "last_name"=>"Rowland Hogue", "scopus_author_id"=>"6506215698"}, {"first_name"=>"Michael W.", "last_name"=>"Varner", "scopus_author_id"=>"35395177900"}, {"first_name"=>"Deborah L.", "last_name"=>"Conway", "scopus_author_id"=>"16443915800"}, {"first_name"=>"Donald", "last_name"=>"Coustan", "scopus_author_id"=>"7005789345"}, {"first_name"=>"Robert L.", "last_name"=>"Goldenberg", "scopus_author_id"=>"35391136800"}, {"first_name"=>"Reverend Phillip", "last_name"=>"Cato", "scopus_author_id"=>"56157117600"}, {"first_name"=>"James W.", "last_name"=>"Collins", "scopus_author_id"=>"55553735731"}, {"first_name"=>"Terry", "last_name"=>"Dwyer", "scopus_author_id"=>"56156722000"}, {"first_name"=>"William P.", "last_name"=>"Fifer", "scopus_author_id"=>"7006887064"}, {"first_name"=>"John", "last_name"=>"Ilekis", "scopus_author_id"=>"56706547100"}, {"first_name"=>"Marc", "last_name"=>"Incerpi", "scopus_author_id"=>"6602629685"}, {"first_name"=>"George", "last_name"=>"Macones", "scopus_author_id"=>"7006468240"}, {"first_name"=>"M.", "last_name"=>"Richard", "scopus_author_id"=>"18838282100"}, {"first_name"=>"Raymond W.", "last_name"=>"Redline", "scopus_author_id"=>"7005225831"}, {"first_name"=>"Elizabeth Thom", "last_name"=>"Thom", "scopus_author_id"=>"7005162459"}], "year"=>2014, "source"=>"PLoS Medicine", "identifiers"=>{"pmid"=>"24755550", "doi"=>"10.1371/journal.pmed.1001633", "sgr"=>"84900408655", "isbn"=>"1549-1676", "scopus"=>"2-s2.0-84900408655", "issn"=>"15491676", "pui"=>"373076986"}, "id"=>"2453a15f-a7c2-3d91-aa1f-d54f54cd6028", "abstract"=>"BACKGROUND: Stillbirth is strongly related to impaired fetal growth. However, the relationship between fetal growth and stillbirth is difficult to determine because of uncertainty in the timing of death and confounding characteristics affecting normal fetal growth.\\n\\nMETHODS AND FINDINGS: We conducted a population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in five geographic areas in the US. Fetal growth abnormalities were categorized as small for gestational age (SGA) (<10th percentile) or large for gestational age (LGA) (>90th percentile) at death (stillbirth) or delivery (live birth) using population, ultrasound, and individualized norms. Gestational age at death was determined using an algorithm that considered the time-of-death interval, postmortem examination, and reliability of the gestational age estimate. Data were weighted to account for the sampling design and differential participation rates in various subgroups. Among 527 singleton stillbirths and 1,821 singleton live births studied, stillbirth was associated with SGA based on population, ultrasound, and individualized norms (odds ratio [OR] [95% CI]: 3.0 [2.2 to 4.0]; 4.7 [3.7 to 5.9]; 4.6 [3.6 to 5.9], respectively). LGA was also associated with increased risk of stillbirth using ultrasound and individualized norms (OR [95% CI]: 3.5 [2.4 to 5.0]; 2.3 [1.7 to 3.1], respectively), but not population norms (OR [95% CI]: 0.6 [0.4 to 1.0]). The associations were stronger with more severe SGA and LGA (<5th and >95th percentile). Analyses adjusted for stillbirth risk factors, subset analyses excluding potential confounders, and analyses in preterm and term pregnancies showed similar patterns of association. In this study 70% of cases and 63% of controls agreed to participate. Analysis weights accounted for differences between consenting and non-consenting women. Some of the characteristics used for individualized fetal growth estimates were missing and were replaced with reference values. However, a sensitivity analysis using individualized norms based on the subset of stillbirths and live births with non-missing variables showed similar findings.\\n\\nCONCLUSIONS: Stillbirth is associated with both growth restriction and excessive fetal growth. These findings suggest that, contrary to current practices and recommendations, stillbirth prevention strategies should focus on both severe SGA and severe LGA pregnancies. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/fetal-growth-risk-stillbirth-populationbased-casecontrol-study", "reader_count"=>54, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>6, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>6, "Student > Master"=>6, "Other"=>4, "Student > Bachelor"=>7, "Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>6, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>6, "Student > Master"=>6, "Other"=>4, "Student > Bachelor"=>7, "Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Environmental Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>4, "Medicine and Dentistry"=>37, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Business, Management and Accounting"=>1, "Psychology"=>1, "Social Sciences"=>4, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>37}, "Social Sciences"=>{"Social Sciences"=>4}, "Psychology"=>{"Psychology"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>2}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Norway"=>1, "United Kingdom"=>2}, "group_count"=>1}

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Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1555625"], "description"=>"a<p>Information was missing as follows (unweighted missing <i>n</i> for stillbirths and live births, respectively): paternal age (44 and 98), maternal race/ethnicity (1 stillbirth), BMI (21 and 42), maternal education (36 and 82), marital status (34 and 76), insurance (3 and 4), family income (40 and 90), blood type (5 and 6), Rh factor (2 and 6), cigarette smoking (34 and 78), alcohol consumption (37 and 81), drug use (38 and 91), hypertension (2 and 5), diabetes (1 and 5), seizure disorder (2 and 6), male sex (5 and 2).</p><p>Percentages may not sum to 100 because of rounding.</p>b<p><i>p</i>-Value for a difference between stillbirths and live births by the median test (continuous variables) or the Wald chi-square test (categorical variables).</p>c<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>Unweighted sample sizes were 527 stillbirths and 1,821 live births.</p>d<p>Average number of cigarettes smoked per day during the 3 mo prior to pregnancy or alcohol consumption during the 3 mo prior to pregnancy.</p><p>Drank without bingeing was defined as 0–6 drinks in a typical week and no occasion where four or more drinks were consumed in a single time period (“binge”). Bingeing was defined as at least one binge and/or seven or more drinks in a typical week.</p>e<p>GA at death (stillbirths) or delivery (live births) by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>.</p><p>HMO, health maintenance organization; VA, Veterans Affairs.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "stillbirth"], "article_id"=>1075309, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t001", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_stillbirth_and_live_birth_pregnancies_/1075309", "title"=>"Characteristics of stillbirth and live birth pregnancies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555624"], "description"=>"<p>Birth weight for GA at death (stillbirths) or delivery (live births) by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. Percentages may add to slightly more or less than 100% because of rounding.</p>a<p>Unadjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that included effects for percentile group only.</p>b<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>In the subset used to assess risk of preterm stillbirth, unweighted sample sizes were 433 preterm stillbirths and 1,821 (preterm and term) live births. In the subset of term pregnancies, unweighted sample sizes were 94 stillbirths and 1,386 live births.</p>c<p>Individualized norm percentiles were derived using the fetal weight for GA equation from Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p>d<p>Ultrasound norm percentiles were derived using the fetal weight for GA equation and standard error from Hadlock et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Hadlock1\" target=\"_blank\">[19]</a>.</p>e<p>Alexander et al. population norm percentiles of birth weight for GA were used <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Alexander1\" target=\"_blank\">[18]</a>.</p><p>Simple linear interpolation was used with the Alexander et al. birth weight percentiles reported for completed weeks of GA in whole weeks to derive birth weight percentiles for GA in weeks and days.</p><p>LB, live birth; SB, stillbirth.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "percentiles", "preterm", "stillbirths"], "article_id"=>1075308, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t007", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Birth_weight_percentiles_among_preterm_and_term_stillbirths_and_live_births_/1075308", "title"=>"Birth weight percentiles among preterm and term stillbirths and live births.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555621"], "description"=>"<p>Birth weight for GA at death (stillbirths) or delivery (live births) by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. Stillbirths and live births in women with pregestational (type 1 or type 2) or gestational diabetes or with chronic hypertension or gestational hypertension/preeclampsia were excluded from the subset without maternal diabetes. Stillbirths and live births with malformations or chromosomal abnormalities or who were estimated to be <24 wk gestation at death or delivery were excluded from the non-anomalous subset. The subset with optimal estimation of GA is defined below. Percentages may add to slightly more or less than 100% because of rounding.</p>a<p>In this subset, GA was estimated using an expected due date based on an ultrasound examination at ≤20 wk 6 d or last menstrual period that agreed with that ultrasound, and for stillbirths there was an interval of 7 d or fewer between the date the fetus was last recorded alive and the date fetal demise was first reported.</p>b<p>Unadjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that included effects for percentile group only.</p><p>The ORs adjusted for stillbirth risk factors as defined in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed-1001633-t004\" target=\"_blank\">Table 4</a>, footnote b (excluding adjustment for pregestational hypertension and pregestational diabetes in the subset without maternal diabetes or hypertension), were similar and are not shown.</p>c<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>In the subset of pregnancies without maternal diabetes or hypertension/preeclampsia, unweighted sample sizes were 384 stillbirths and 1,402 live births. In the subset of non-anomalous singletons ≥24 wk gestation, unweighted sample sizes were 315 stillbirths and 1,661 live births. In the subset with optimalestimation of GA, unweighted sample sizes were 199 stillbirths and 1,226 live births.</p>d<p>Individualized norm percentiles were derived using the fetal weight for GA equation from Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p>e<p>Ultrasound norm percentiles were derived using the fetal weight for GA equation and standard error from Hadlock et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Hadlock1\" target=\"_blank\">[19]</a>.</p>f<p>Alexander et al. population norm percentiles of birth weight for GA were used <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Alexander1\" target=\"_blank\">[18]</a>.</p><p>Simple linear interpolation was used with the Alexander et al. birth weight percentiles reported for completed weeks of GA in whole weeks to derive birth weight percentiles for GA in weeks and days.</p><p>LB, live birth; SB, stillbirth.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "percentiles", "subsets", "stillbirths"], "article_id"=>1075305, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t005", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Birth_weight_percentiles_among_subsets_of_stillbirths_and_live_births_/1075305", "title"=>"Birth weight percentiles among subsets of stillbirths and live births.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555619"], "description"=>"<p>Birth weight for GA at death (stillbirths) or delivery (live births) by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. Percentages may add to slightly more or less than 100% because of rounding.</p>a<p>Unadjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that included effects for percentile group only.</p>b<p>Adjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that in addition to the percentile group indicators included study site number; paternal age (<20, 20–34, 35–39, ≥40 y); the following maternal variables (categorized as shown in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed-1001633-t001\" target=\"_blank\">Table 1</a> or as noted): maternal age (<20, 20–34, 35–39, ≥40 y), race/ethnicity, education, marital status, insurance, family income, smoking during the 3 mo prior to pregnancy, alcohol use during the 3 mo prior to pregnancy, drug use, BMI, blood type, Rh factor, pregestational hypertension, pregestational diabetes, seizure disorder, and pregnancy history; and infant sex.</p>c<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>Unweighted sample sizes were 527 stillbirths and 1,821 live births. Unweighted (weighted) sample sizes included in computation of adjusted ORs were 452 (451) stillbirths and 1,665 (1,261) live births.</p>d<p>Individualized norm percentiles were derived using the fetal weight for GA equation from Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p>e<p>Ultrasound norm percentiles were derived using the fetal weight for GA equation and standard error from Hadlock et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Hadlock1\" target=\"_blank\">[19]</a>.</p>f<p>Alexander et al. population norm percentiles of birth weight for GA were used <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Alexander1\" target=\"_blank\">[18]</a>.</p><p>Simple linear interpolation was used with the Alexander birth weight percentiles reported for completed weeks of GA in whole weeks to derive birth weight percentiles for GA in weeks and days.</p><p>LB, live birth; SB, stillbirth.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "percentiles", "stillbirths"], "article_id"=>1075303, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t004", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Birth_weight_percentiles_among_stillbirths_and_live_births_/1075303", "title"=>"Birth weight percentiles among stillbirths and live births.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555632"], "description"=>"<div><p>Background</p><p>Stillbirth is strongly related to impaired fetal growth. However, the relationship between fetal growth and stillbirth is difficult to determine because of uncertainty in the timing of death and confounding characteristics affecting normal fetal growth.</p><p>Methods and Findings</p><p>We conducted a population-based case–control study of all stillbirths and a representative sample of live births in 59 hospitals in five geographic areas in the US. Fetal growth abnormalities were categorized as small for gestational age (SGA) (<10th percentile) or large for gestational age (LGA) (>90th percentile) at death (stillbirth) or delivery (live birth) using population, ultrasound, and individualized norms. Gestational age at death was determined using an algorithm that considered the time-of-death interval, postmortem examination, and reliability of the gestational age estimate. Data were weighted to account for the sampling design and differential participation rates in various subgroups. Among 527 singleton stillbirths and 1,821 singleton live births studied, stillbirth was associated with SGA based on population, ultrasound, and individualized norms (odds ratio [OR] [95% CI]: 3.0 [2.2 to 4.0]; 4.7 [3.7 to 5.9]; 4.6 [3.6 to 5.9], respectively). LGA was also associated with increased risk of stillbirth using ultrasound and individualized norms (OR [95% CI]: 3.5 [2.4 to 5.0]; 2.3 [1.7 to 3.1], respectively), but not population norms (OR [95% CI]: 0.6 [0.4 to 1.0]). The associations were stronger with more severe SGA and LGA (<5th and >95th percentile). Analyses adjusted for stillbirth risk factors, subset analyses excluding potential confounders, and analyses in preterm and term pregnancies showed similar patterns of association. In this study 70% of cases and 63% of controls agreed to participate. Analysis weights accounted for differences between consenting and non-consenting women. Some of the characteristics used for individualized fetal growth estimates were missing and were replaced with reference values. However, a sensitivity analysis using individualized norms based on the subset of stillbirths and live births with non-missing variables showed similar findings.</p><p>Conclusions</p><p>Stillbirth is associated with both growth restriction and excessive fetal growth. These findings suggest that, contrary to current practices and recommendations, stillbirth prevention strategies should focus on both severe SGA and severe LGA pregnancies.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "population-based"], "article_id"=>1075316, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633", "stats"=>{"downloads"=>1, "page_views"=>29, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Fetal_Growth_and_Risk_of_Stillbirth_A_Population_Based_Case_8211_Control_Study_/1075316", "title"=>"Fetal Growth and Risk of Stillbirth: A Population-Based Case–Control Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555627"], "description"=>"<p>Birth weight for GA at death (stillbirths) or delivery (live births) by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. Percentages may add to slightly more or less than 100% because of rounding.</p>a<p>Unadjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that included effects for percentile group only.</p>b<p>Adjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that in addition to the percentile group indicators included study site number; paternal age (<20, 20–34, 35–39, ≥40 y); the following maternal variables (categorized as shown in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed-1001633-t001\" target=\"_blank\">Table 1</a> or as noted): maternal age (<20, 20–34, 35–39, ≥40 y), race/ethnicity, education, marital status, insurance/method of payment, family income, smoking during the 3 mo prior to pregnancy, alcohol use during the 3 mo prior to pregnancy, drug use, BMI, blood type, Rh factor, pregestational hypertension, pregestational diabetes, seizure disorder, and pregnancy history; and infant sex.</p>c<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>Unweighted sample sizes were 527 stillbirths and 1,821 live births. Unweighted (weighted) sample sizes included in computation of adjusted ORs were 452 (451) stillbirths and 1,665 (1,261) live births.</p>d<p>Individualized norm percentiles were derived using the fetal weight equation from Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p><p>All 19 variables were used in the fetal equation here. (Fetal heart rate was included in the original Bukowski equation but was not collected by the SCRN study. GA in days minus 280 d drops out of the equation when predicting birth weight at 280 d.)</p>e<p>Individualized norm percentiles were derived using the subset of 11 variables largely non-missing in the SCRN cohort in the fetal weight equation to predict term birth weight: maternal weight, height, race/ethnicity, education, marital status, number of prior term pregnancies, number of prior abortions, altitude of residence, use of ovulation induction to become pregnant, cigarettes smoked per day during the first trimester, and male fetus.</p>f<p>Individualized norm percentiles were derived using the subset of six variables suggested by Gardosi et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Gardosi1\" target=\"_blank\">[20]</a> in the fetal weight equation to predict term birth weight (excluding GA, which drops out): maternal weight, height, race/ethnicity, number of prior term pregnancies, cigarettes smoked per day during the first trimester, and male fetus.</p>g<p>Individualized norm percentiles were derived using a subset of five variables (the six variables above minus number of cigarettes smoked) in the fetal weight equation to predict term birth weight: maternal weight, height, race/ethnicity, number of prior term pregnancies, and male fetus.</p><p>LB, live birth; SB, stillbirth.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "percentiles", "stillbirths", "births", "equations", "individualized"], "article_id"=>1075311, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t003", "stats"=>{"downloads"=>2, "page_views"=>25, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Birth_weight_percentiles_among_stillbirths_and_live_births_using_different_equations_to_estimate_individualized_expected_weight_/1075311", "title"=>"Birth weight percentiles among stillbirths and live births using different equations to estimate individualized expected weight.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555626"], "description"=>"<p>Variables used to compute individualized expected birth weight at 280(unweighted <i>n</i> = 2,348).</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "compute", "individualized"], "article_id"=>1075310, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t002", "stats"=>{"downloads"=>7, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Variables_used_to_compute_individualized_expected_birth_weight_at_280_unweighted_n_2_348_/1075310", "title"=>"Variables used to compute individualized expected birth weight at 280(unweighted <i>n</i> = 2,348).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555622"], "description"=>"<p>Birth weight percentiles for stillbirths ≥20 wk gestation using three GA estimates: GA at delivery, GA at delivery minus 2 d, and GA at death estimated using the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. Percentages may add to slightly more or less than 100% because of rounding.</p>a<p>Unadjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that included effects for percentile group only.</p>b<p>Adjusted OR for stillbirth for infants with birth weight in the percentile group shown compared to infants in the reference group from a logistic regression model that in addition to the percentile group indicators included study site number; paternal age (<20, 20–34, 35–39, ≥40 y); the following maternal variables (categorized as shown in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed-1001633-t001\" target=\"_blank\">Table 1</a> or as noted): maternal age (<20, 20–34, 35–39, ≥40 y), race/ethnicity, education, marital status, insurance, family income, smoking during the 3 mo prior to pregnancy, alcohol use during the 3 mo prior to pregnancy, drug use, BMI, blood type, Rh factor, pregestational hypertension, pregestational diabetes, seizure disorder, and pregnancy history; and infant sex.</p>c<p>Analysis weights that accounted for the basic study design plus other aspects of the sampling were used.</p><p>Unweighted sample sizes were 527, 561, and 570 stillbirths for GA at death, GA at delivery minus 2 d, and GA at delivery, respectively, and 1,821 live births. Unweighted (weighted) sample sizes included in computation of adjusted ORs were 491 (489) stillbirths and 1,665 (1,261) live births.</p>d<p>Individualized norm percentiles were derived using the fetal weight for GA equation from Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p>e<p>Ultrasound norm percentiles were derived using the fetal weight for GA equation and standard error from Hadlock et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Hadlock1\" target=\"_blank\">[19]</a>.</p>f<p>Alexander et al. population norm percentiles of birth weight for GA were used <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Alexander1\" target=\"_blank\">[18]</a>.</p><p>Simple linear interpolation was used with the Alexander et al. birth weight percentiles reported for completed weeks of GA in whole weeks to derive birth weight percentiles for GA in weeks and days.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "percentiles", "ga", "estimates", "singleton"], "article_id"=>1075306, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.t006", "stats"=>{"downloads"=>3, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Birth_weight_percentiles_in_relation_to_different_GA_estimates_among_singleton_stillbirths_/1075306", "title"=>"Birth weight percentiles in relation to different GA estimates among singleton stillbirths.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555618"], "description"=>"<p>Study enrollment and inclusion in analysis.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "enrollment", "inclusion"], "article_id"=>1075301, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.g002", "stats"=>{"downloads"=>2, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_enrollment_and_inclusion_in_analysis_/1075301", "title"=>"Study enrollment and inclusion in analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-04-22 10:33:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/1555611"], "description"=>"<p>GA<sub>SCRN</sub> is the fetal age at death (for stillbirths) or delivery (for live births) estimated by the SCRN algorithm <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Conway1\" target=\"_blank\">[17]</a>. BW, birth weight; SD, standard deviation. References: Alexander et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Alexander1\" target=\"_blank\">[18]</a>, Hadlock et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Hadlock1\" target=\"_blank\">[19]</a>; Bukowski et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001633#pmed.1001633-Bukowski1\" target=\"_blank\">[15]</a>.</p>", "links"=>[], "tags"=>["women's health", "Maternal health", "pregnancy", "Miscarriage and stillbirth", "Obstetrics and gynecology", "steps", "infants", "percentile"], "article_id"=>1075295, "categories"=>["Biological Sciences"], "users"=>["Radek Bukowski", "Nellie I. Hansen", "Marian Willinger", "Uma M. Reddy", "Corette B. Parker", "Halit Pinar", "Robert M. Silver", "Donald J. Dudley", "Barbara J. Stoll", "George R. Saade", "Matthew A. Koch", "Carol J. Rowland Hogue", "Michael W. Varner", "Deborah L. Conway", "Donald Coustan", "Robert L. Goldenberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001633.g001", "stats"=>{"downloads"=>4, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_steps_used_to_assign_infants_to_a_birth_weight_percentile_category_/1075295", "title"=>"Summary of steps used to assign infants to a birth weight percentile category.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-04-22 10:33:21"}

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Relative Metric

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