Factors contributing to intra-uterine fetal death.

Purpose: We aimed in this research to explore factors contributing to the occurrence of intra-uterine fetal death (IUFD).

Methods: The study was conducted between 1st January 2008 and 31st December 2009 in the Department of Obstetrics and Gynecology at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Patients who were diagnosed to have IUFD at ≥24 weeks of gestation and those whose dead fetuses were found to weigh ≥500 g after delivery were eligible to be included. 138 patients with IUFD and 237 controls with alive fetuses were enrolled. Data were collected from printed and computerized medical records of participants. Factors that may have contributed to the occurrence of IUFD were explored. Comparisons between various risk factors and outcomes of the two groups were done. p value was statistically significant if ≤0.05.

Results: Patients who did not receive antenatal care (ANC) services are at 70 % increased risk for developing IUFD (OR 0.31, p < 0.0001). Risk of IUFD increases 25-fold with the occurrence of abruption placenta (OR 25.81, p ≤ 0.0001), tenfolds with the occurrence of intra-uterine growth restrictions (OR 10.78, p = 0.04) and threefolds with the presence of hypertensive disorder in pregnancy (OR 3.17, p = 0.04). Finally, patients carrying IUFD fetuses are at higher risk to develop labor complications compared with their controls (p ≤ 0.0001).

Conclusion: Despite the difficulty in predicting IUFD occurrence, it appears that carefully implemented ANC and timely management of at risk patients may contribute to its prevention.