Ethnicity and the risk of late-pregnancy stillbirth

To determine if maternal country of birth is associated with the risk of antepartum stillbirth in late pregnancy. Design, setting and participants: Retrospective cross-sectional study of all singleton births at 37-42 weeks gestation, excluding those with congenital abnormalities and intrapartum stillbirths, between 1 June 2001 and 31 May 2011 at Southern Health, a large metropolitan maternity service in Melbourne, Australia. MAIN OUTCOME MEASURE: Rate of late-pregnancy antepartum stillbirth, analysed by maternal country of birth. Results: Among 44 326 births, there was a significant difference in the stillbirth rate by maternal country of birth (P <0.001). The rate of stillbirth per 1000 births was 1.48 among Australian-born women, 3.55 among South Asian-born women and 1.06 among South-East-East Asian-born women. Women born in South Asia were 2.4 (95 CI, 1.4-4.0) times more likely to have a late-pregnancy stillbirth than women born in Australia (P <0.001). There was no significant difference between women born in Australia and women born in South-East-East Asia (P = 0.34). Adjusting for potential confounding factors, South Asian maternal birth remained an independent risk factor for stillbirth (adjusted odds ratio, 2.5; 95 CI, 1.3-5.1; P = 0.009). CONCLUSION: Women born in South Asia have an increased risk of antepartum stillbirth in late pregnancy, compared with other women. This observation may have implications for the delivery of pregnancy care in Australia.