Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jul;45(7):971-976.
doi: 10.1038/s41372-025-02253-w. Epub 2025 Mar 6.

Diagnostic evaluation to identify infection-attributable stillbirth

Sarah A Coggins  1   2   3 , Jourdan E Triebwasser  4 , Karen M Puopolo  5   6   7
Affiliations
Multicenter Study

Diagnostic evaluation to identify infection-attributable stillbirth

Sarah A Coggins et al. J Perinatol. 2025 Jul.

Abstract

Objective: To characterize stillbirth evaluations, including the frequency and yield of investigations for infections causing stillbirth.

Study design: Retrospective cohort of stillbirths at three university-affiliated perinatal centers from 2017 to 2022. The primary outcome was adherence to American College of Obstetrics and Gynecology core stillbirth evaluation recommendations (placental pathology, fetal autopsy, and fetal genetic testing). We further characterized the prevalence and yield of specific testing to evaluate for infection-attributable stillbirth etiologies.

Results: The cohort included 399 stillbirths. Placental pathology was performed in 387 cases (97.0%), fetal genetic testing in 163 (40.9%), and fetal autopsy in 126 (31.6%). Fetal bacterial cultures were obtained in 73 (18.2%) cases; potential pathogens were isolated in 21/73 (28.8%). Viral testing was sent infrequently, with variable yield. Six stillbirths had infections identified as probable etiologies.

Conclusions: Adherence to core stillbirth evaluation recommendations was poor, and infection testing was infrequent. Infection-attributable stillbirth prevalence may be underestimated.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to publish: This study was approved as exempt human subjects research by the University of Pennsylvania Institutional Review Board and was granted a waiver of informed consent (IRB #853454). All methods were performed in accordance with the relevant guidelines and regulations.

References

    1. Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387:587–603. - PubMed
    1. Gregory ECW, Valenzuela CP, Hoyert DL. Fetal Mortality: United States, 2021. Natl Vital Stat Rep. 2023;72. Available from: https://www.cdc.gov/nchs/products/index.htm. - PubMed
    1. Matthews RJ, Draper ES, Manktelow BN, Kurinczuk JJ, Fenton AC, Dunkley-Bent J, et al. Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study. BMJ Open. 2022;12:e057412. - PMC - PubMed
    1. Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, et al. Major risk factors for stillbirth in high-income countries: A systematic review and meta-analysis. Lancet. 2011;377:1331–40. 10.1016/S0140-6736(10)62233-7. - PubMed
    1. Gandhi C, Page J. Stillbirth risk factors, causes and evaluation. Semin Perinatol. 2024;48:151867 - PubMed

Publication types

LinkOut - more resources