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Infectious Diseases in Obstetrics and Gynecology
Volume 2011, Article ID 456728, 7 pages
Research Article

Histological Chorioamnionitis Is Increased at Extremes of Gestation in Stillbirth: A Population-Based Study

1Department of Neonatal Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
2Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

Received 4 March 2011; Accepted 16 June 2011

Academic Editor: Francesco DeSeta

Copyright © 2011 Adrienne Gordon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To determine the incidence of histological chorioamnionitis and a fetal response in stillbirths in New South Wales (NSW), and to examine any relationship of fetal response to spontaneous onset of labour and to unexplained antepartum death. Study Design. Population-based cohort study. Setting. New South Wales Australia. Population. All births between 2002 and 2004 with stillbirths reviewed and classified by the state perinatal mortality review committee. Methods. Record linkage of the Midwives Data Collection and the Perinatal Death Database including placental histopathology and standardised cause of death classification. Results. 952 stillbirths were included. The incidence of histopathological chorioamnionitis was 22.6%, with a bimodal distribution. A fetal inflammatory response was present in 10.1% and significantly correlated with spontaneous onset of labour. The absence of a fetal inflammatory response was strongly associated with unexplained antepartum death. Conclusions. The increased incidence of histological chorioamnionitis at extremes of gestation is confirmed in the largest dataset to date using population data. This has important implications for late gestation stillbirth as the percentage of unexplained stillbirths increases near term.