Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study.

Introduction: Stillbirth remains an important public health problem in Australia and New Zealand. The role that antenatal care plays in the prevention of stillbirth in high-income countries is unclear.

Methods: Cases were women with a singleton, late stillbirth without congenital abnormality, booked to deliver in the Auckland region and born between July 2006 and June 2009.

Association between maternal sleep practices and risk of late stillbirth: a case-control study.

Objectives: To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.

Design: Prospective population based case-control study.

Setting: Auckland, New Zealand

Cases: 155 women with a singleton late stillbirth (≥ 28 weeks' gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland.

The Auckland Stillbirth study, a case-control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale.

Background: In high-income countries, stillbirth rates have been static in recent decades. Unexplained stillbirths account for up to 50% of these deaths.

Methods: A case-control study was conducted in Auckland, New Zealand, from July 2006 to June 2009 to explore modifiable risk factors for late stillbirth (≥28 weeks of gestation).

Relationship between obesity, ethnicity and risk of late stillbirth: a case control study.

Background: In high income countries there has been little improvement in stillbirth rates over the past two decades. Previous studies have indicated an ethnic disparity in the rate of stillbirths. This study aimed to determine whether maternal ethnicity is independently associated with late stillbirth in New Zealand.

Forensic issues in cases of water birth fatalities.

Birth under water has become a widely disseminated technique that is promoted to improve the quality of labor. The case of a 42-week gestation male infant is reported who died of respiratory and multiorgan failure secondary to florid pneumonia and sepsis due Pseudomonas aeruginosa following a water birth. Other infants who have been delivered underwater have drowned or have had near-drowning episodes with significant hyponatremia and water intoxication.

Risk factors for and timing of death of extremely preterm infants.

This study examined risk factors for timing and cause of death for extremely preterm infants > or = 23 weeks and < 28 weeks. There were 479 liveborn infants and 98 deaths reviewed over a ten-year period. Thirty-two deaths (33%) occurred on the first day of life and 72 (75%) in the first month of life.

Sudden unexpected infant death and bedsharing: referrals to the Wellington Coroner 1997-2006.

Aims: To describe the factors associated with sudden unexpected infant deaths, for which there was no clear medical diagnosis, referred to the Wellington-based coronial paediatric pathology service over the decade from 1997 to 2006.

Methods: The postmortem report, Police 47 file, Coroner's findings and deceased infant's medical records were used to create a profile for each sudden and unexpected infant death.

Results: There were 64 deaths in the period: 54 of these occurred during sleep and did not have a clear medical diagnosis.

Failure of apnea monitoring during bed-sharing.

We report the case of an infant found dead in bed with an adult while attached to a respiratory monitor sensor. We experimentally re-created a bed-sharing situation with an infant mannequin to demonstrate that a Graseby home apnea monitor continues to sense adult breathing and movement in the absence of infant breathing when used in this sleep situation.

Histopathology and ultrastructure of human umbilical blood vessels.

To resolve controversy over umbilical vessels structure, a morphological review was undertaken of the histology of blood vessels in 130 fetal umbilical cords varying in gestational age and the ultrastructure of blood vessels in 6 umbilical cords. Arteries and veins were lined by endothelium. The internal elastic lamina was frequently interrupted when associated with intimal thickening of longitudinally orientated smooth muscle cells.

Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?

Background: Case review after fatal perinatal asphyxia may have medicolegal implications. Accurate diagnosis of cause of death is therefore essential.

Objective: To determine consent rate and utility of autopsy after fatal grade III hypoxic ischaemic encephalopathy (HIE) presumed to be secondary to birth asphyxia.