Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Epidemiology

Poster Session 2

(407) Development and validation of an early-pregnancy score predictive of stillbirths: an Italian population-based study

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Although stillbirth rates in high-income countries have decreased significantly, ending preventable stillbirth is still a major global public health challenge. We developed a score to determine the risk of stillbirth at an early stage of pregnancy to guarantee the appropriate antenatal identification and prevent intrauterine fetal demise using an Italian population-based cohort.

Study Design:

We conducted a population-based cohort study including 316,149 deliveries with gestational age between 22 and 42 weeks of women aged 15-55 years from January 2017 to December 2021 in the Lombardy region of Italy using the administrative database. A StillBirth score (SB score) was built considering the independent variables able to explain the stillbirth at the 22 gestational weeks selected through a logistic regression model. A weight proportional to the coefficient estimated by the model was assigned to each of the selected variables contributing to the SB score. Discrimination and calibration of the SB score were assessed using an internal validation set. Moreover, we evaluated the risk of stillbirth among the risk classes based on the SB score (i.e., low ≤5 points, intermediate 6-8 points, high ≥9 points).


Results: We identified 869 cases of stillbirth with an incidence rate of 2.7 x1000 person-year. The AUC of the SB score was 65% in the training set and 60% in the validation set. Analysis showed a 1.4-fold (95% IC: 1.1-1.7) greater risk of experiencing the outcome of interest among deliveries with intermediate SB score and a 2.4-fold (95% IC: 2.0-2.8) greater risk among deliveries with high SB score, respectively to deliveries with a low SB score.

Conclusion: Despite the limited discriminatory power, the SB score can stratify women according to their risk of stillbirth, allowing the early identification of mothers who are more likely to have a stillbirth and facilitating appropriate monitoring and timely intervention based on individual risk factors.