Observational studyJournal of perinatal medicine2019
Mechanisms of death in structurally normal stillbirths.
Observational study in Journal of perinatal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05901688 (Umbilical Cord Abnormalities in the Prediction of Adverse Pregnancy Outcomes), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Umbilical Cord Abnormalities in the Prediction of Adverse Pregnancy Outcomes
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Risk Factors and Outcomes Associated With Delayed Villous Maturation in Placenta: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- New biomarkers for the detection of fetal death derived from large-scale proteomic analysis of maternal plasma.American journal of obstetrics and gynecology · 2026Article
- Placental pathology in gestational diabetes mellitus: Associations with neonatal outcomes and postpartum dysglycemia.Acta obstetricia et gynecologica Scandinavica · 2026Observational
- Maternal Circulating sFlt-1:PlGF Ratio and Stillbirth.JAMA network open · 2026Article
- Correlation of changes in circulating levels of hypoxia-induced factor-1α, erythropoietin, and cell-free fetal hemoglobin with feto-maternal pregnancy outcomes.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2025Article
- Circadian patterns of heart rate variability in fetal sheep after hypoxia-ischaemia: A biomarker of evolving brain injury.The Journal of physiology · 2024Article
- Fetal cardiac troponin I levels decline toward birth in sheep.American journal of physiology. Heart and circulatory physiology · 2024Article
- Proteomic profile of extracellular vesicles in maternal plasma of women with fetal death.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2023Article
- Article
- Association of Placental Histology with the Pulsatility Index of Fetal and Uteroplacental Vessels during Pregnancy and with Birthweight Z-Score.Medical research archives · 2023Article
- Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia.PLoS neglected tropical diseases · 2022Article
- Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology.American journal of obstetrics and gynecology · 2022Article
- The role of the placenta in spontaneous preterm labor and delivery with intact membranes.Journal of perinatal medicine · 2022Observational
- Pathophysiology of Perinatal Asphyxia in Humans and Animal Models.Biomedicines · 2022Review
- Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses.Frontiers in physiology · 2022Review
- Non-invasive transabdominal measurement of placental oxygenation: a step toward continuous monitoring.Biomedical optics express · 2021Article
- Disorders of placental villous maturation are present in one-third of cases with spontaneous preterm labor.Journal of perinatal medicine · 2021Article
- Placental delayed villous maturation is associated with evidence of chronic fetal hypoxia.Journal of perinatal medicine · 2020Article
- Disorders of placental villous maturation in fetal death.Journal of perinatal medicine · 2020Article
- Maternal exposure to heat and its association with miscarriage in rural KwaZulu-Natal, South Africa: A population-based cohort study.Women's health (London, England)Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
Objectives To investigate mechanisms of in utero death in normally formed fetuses by measuring amniotic fluid (AF) biomarkers for hypoxia (erythropoietin [EPO]), myocardial damage (cardiac troponin I [cTnI]) and brain injury (glial fibrillary acidic protein [GFAP]), correlated with risk factors for fetal death and placental histopathology. Methods This retrospective, observational cohort study included intrauterine deaths with transabdominal amniocentesis prior to induction of labor. Women with a normal pregnancy and an indicated amniocentesis at term were randomly selected as controls. AF was assayed for EPO, cTnI and GFAP using commercial immunoassays. Placental histopathology was reviewed, and CD15-immunohistochemistry was used. Analyte concentrations >90th centile for controls were considered "raised". Raised AF EPO, AF cTnI and AF GFAP concentrations were considered evidence of hypoxia, myocardial and brain injury, respectively. Results There were 60 cases and 60 controls. Hypoxia was present in 88% (53/60), myocardial damage in 70% (42/60) and brain injury in 45% (27/60) of fetal deaths. Hypoxic fetuses had evidence of myocardial injury, brain injury or both in 77% (41/53), 49% (26/53) and 13% (7/53) of cases, respectively. Histopathological evidence for placental dysfunction was found in 74% (43/58) of these cases. Conclusion Hypoxia, secondary to placental dysfunction, was found to be the mechanism of death in the majority of fetal deaths among structurally normal fetuses. Ninety-one percent of hypoxic fetal deaths sustained brain, myocardial or both brain and myocardial injuries in utero. Hypoxic myocardial injury was an attributable mechanism of death in 70% of the cases. Non-hypoxic cases may be caused by cardiac arrhythmia secondary to a cardiac conduction defect.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.