Evidence map›Paper›PMID 42130018›Full record

ArticleThe Australian & New Zealand journal of obstetrics & gynaecology2026

Clinical Utility of Stillbirth Investigations in Australia: A Cohort Study.

Tania Marsden, Mu Cheng, T Yee Khong, Jane E Dahlstrom, David Ellwood, Ali Moghimi, Stacey Prystupa, Cecilia Obrien, Fathima S Cassim, Skye Martin and 13 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in The Australian & New Zealand journal of obstetrics & gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Tania MarsdenNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.ORCID https://orcid.org/0000-0003-1270-1122
Mu ChengNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.
T Yee KhongSA Pathology, Women's and Children's Hospital, Adelaide, Australia.
Jane E DahlstromACT Pathology, Canberra Health Services and School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australia.ORCID https://orcid.org/0000-0001-5608-693X
David EllwoodNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.
Ali MoghimiDepartment of Histopathology, The Children's Hospital, Westmead, New South Wales, Australia.
Stacey PrystupaBUPA, Melbourne, Australia.
Cecilia ObrienConsultant Maternal Fetal Medicine Specialist, Townsville University Hospital, Townsville, Queensland, Australia.
Fathima S CassimATSICHS, Brisbane, Australia.
Skye MartinRegistrar Obstetrics and Gynaecology, Townsville University Hospital, Townsville, Queensland, Australia.
Michael CooryNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.
Frances M BoyleNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.
Heidi ShukrallaPublic Health Registrar, Linear Clinical Research, Perth, Western Australia, Australia.ORCID https://orcid.org/0000-0002-6461-4461
Alison L KentPediatrics University of Rochester School of Medicine and Dentistry, Australian National University, Canberra, Australia.
Ashwati Krishnan VarikaraNSW Health Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID https://orcid.org/0009-0002-9960-7066
Patricia HannafordAnatomical Pathology, Capital Pathology., Canberra, Australia.
Joanne FrostObstetrics and Gynaecology Registrar and Doctoral Candidate, Women's and Newborn Services, Royal Brisbane and Women's Hospital, Faculty of Medicine, The University of Queensland, Brisbane, Australia.ORCID https://orcid.org/0000-0002-5268-9458
Joanna Perry-KeenePathology Queensland, Brisbane, Queensland, Australia.
Gretchen PomareTe Whatu Ora, Health New Zealand, Auckland, New Zealand.
Yin Ping WongDepartment of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Geok Chin TanDeputy Dean of Research and Innovation of the Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Vicki FlenadyNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.
Jessica SextonNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Australia.

Funding

National Health and Medical Research Council 1029613National Health and Medical Research Council AP1116640National Health and Medical Research Council APP2010136
6 · The paper itself

Abstract

backgroundStillbirths impact over two million parents globally every year. Despite current knowledge, technology, and investigations, many stillbirths remain unexplained and are not fully investigated. An important step forward in addressing this gap is determining which investigations produce the highest utility in identifying the cause of death (COD).

aimsThe objective of this study is to identify and define the usefulness or utility of investigations in determining COD among a cohort of stillbirths. MATERIALS AND

methodsProspective cohort study from 2013 to 2018 comprising 695 stillbirths. An expert panel blinded to COD assessed the clinical utility of investigations using a purpose-built tool. A stepwise approach was applied, categorising investigations into three groups: clinical and laboratory investigations; placental pathology; and autopsy examination. Clinical utility of the investigations was defined as the proportion of cases in which each test contributed to the identification of the COD.

resultsPlacental pathology had the highest clinical utility (87%), followed by comprehensive maternal history (82%), genetic analysis (75%), maternal blood investigations for infection (64%), fetal-maternal haemorrhage (FMH) (57%), and fetal autopsy (47%). Placental pathology and genetic analysis were useful across all clinical scenarios, while autopsy was most beneficial when the clinical scenario was unknown. A COD was established in 528 cases (76%), with 310 cases (47%) identified post-placental examination.

conclusionsThe investigations with the highest clinical utility were placental pathology, comprehensive maternal history, genetic analysis, maternal blood investigations, FMH, and fetal autopsy. This study supports a core set of investigations, supplemented by selective tests based on the clinical scenario.

Indexed as

StillbirthAdultAustraliaAutopsyCause of DeathCohort StudiesFemaleHumansPlacentaPregnancyProspective Studiesautopsydeath classificationplacentastillbirth

Identifiers

PMID42130018
PMCPMC13172430

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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.