Prediction of stillbirth: an umbrella review of evaluation of prognostic variables.

Townsend, R; Sileo, FG; Allotey, J; Dodds, J; Heazell, A; Jorgensen, L; Kim, VB; Magee, L; Mol, B; Sandall, J; Smith, G; Thilaganathan, B; von Dadelszen, P; Thangaratinam, S; Khalil, A

Prediction of stillbirth: an umbrella review of evaluation of prognostic variables.

Townsend, R Sileo, FG Allotey, J Dodds, J Heazell, A Jorgensen, L Kim, VB Magee, L Mol, B Sandall, J

Smith, G Thilaganathan, B von Dadelszen, P Thangaratinam, S Khalil, A

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: BJOG : an international journal of obstetrics and gynaecology, 2020, 128, (2), pp. 238-250
Issue Date:: 2020-09-15

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Field	Value	Language
dc.contributor.author	Townsend, R
dc.contributor.author	Sileo, FG
dc.contributor.author	Allotey, J
dc.contributor.author	Dodds, J
dc.contributor.author	Heazell, A
dc.contributor.author	Jorgensen, L
dc.contributor.author	Kim, VB
dc.contributor.author	Magee, L
dc.contributor.author	Mol, B
dc.contributor.author	Sandall, J https://orcid.org/0000-0003-2000-743X
dc.contributor.author	Smith, G
dc.contributor.author	Thilaganathan, B
dc.contributor.author	von Dadelszen, P
dc.contributor.author	Thangaratinam, S
dc.contributor.author	Khalil, A
dc.date.accessioned	2021-01-22T05:06:04Z
dc.date.available	2020-08-17
dc.date.available	2021-01-22T05:06:04Z
dc.date.issued	2020-09-15
dc.identifier.citation	BJOG : an international journal of obstetrics and gynaecology, 2020, 128, (2), pp. 238-250
dc.identifier.issn	1470-0328
dc.identifier.issn	1471-0528
dc.identifier.uri	http://hdl.handle.net/10453/145550
dc.description.abstract	<h4>Background</h4>Stillbirth accounts for over 2 million deaths a year worldwide and rates remains stubbornly high. Multivariable prediction models may be key to individualised monitoring, intervention or early birth in pregnancy to prevent stillbirth.<h4>Objectives</h4>To collate and evaluate systematic reviews of factors associated with stillbirth in order to identify variables relevant to prediction model development.<h4>Search strategy</h4>MEDLINE, Embase, DARE and Cochrane Library databases and reference lists were searched up to November 2019.<h4>Selection criteria</h4>We included systematic reviews of association of individual variables with stillbirth without language restriction.<h4>Data collection and analysis</h4>Abstract screening and data extraction were conducted in duplicate. Methodological quality was assessed using AMSTAR and QUIPS criteria. The evidence supporting association with each variable was graded.<h4>Results</h4>The search identified 1198 citations. Sixty-nine systematic reviews reporting 64 variables were included. The most frequently reported were maternal age (n = 5), body mass index (n = 6) and maternal diabetes (n = 5). Uterine artery Doppler appeared to have the best performance of any single test for stillbirth. The strongest evidence of association was for nulliparity and pre-existing hypertension.<h4>Conclusion</h4>We have identified variables relevant to the development of prediction models for stillbirth. Age, parity and prior adverse pregnancy outcomes had a more convincing association than the best performing tests, which were PAPP-A, PlGF and UtAD. The evidence was limited by high heterogeneity and lack of data on intervention bias.<h4>Tweetable abstract</h4>Review shows key predictors for use in developing models predicting stillbirth include age, prior pregnancy outcome and PAPP-A, PLGF and Uterine artery Doppler.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	BJOG : an international journal of obstetrics and gynaecology
dc.relation.isbasedon	10.1111/1471-0528.16510
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Prediction of stillbirth: an umbrella review of evaluation of prognostic variables.
dc.type	Journal Article
utslib.citation.volume	128
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
dc.date.updated	2021-01-22T05:05:27Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	128
utslib.citation.issue	2

Abstract:

Background

Stillbirth accounts for over 2 million deaths a year worldwide and rates remains stubbornly high. Multivariable prediction models may be key to individualised monitoring, intervention or early birth in pregnancy to prevent stillbirth.

Objectives

To collate and evaluate systematic reviews of factors associated with stillbirth in order to identify variables relevant to prediction model development.

Search strategy

MEDLINE, Embase, DARE and Cochrane Library databases and reference lists were searched up to November 2019.

Selection criteria

We included systematic reviews of association of individual variables with stillbirth without language restriction.

Data collection and analysis

Abstract screening and data extraction were conducted in duplicate. Methodological quality was assessed using AMSTAR and QUIPS criteria. The evidence supporting association with each variable was graded.

Results

The search identified 1198 citations. Sixty-nine systematic reviews reporting 64 variables were included. The most frequently reported were maternal age (n = 5), body mass index (n = 6) and maternal diabetes (n = 5). Uterine artery Doppler appeared to have the best performance of any single test for stillbirth. The strongest evidence of association was for nulliparity and pre-existing hypertension.

Conclusion

We have identified variables relevant to the development of prediction models for stillbirth. Age, parity and prior adverse pregnancy outcomes had a more convincing association than the best performing tests, which were PAPP-A, PlGF and UtAD. The evidence was limited by high heterogeneity and lack of data on intervention bias.

Tweetable abstract

Review shows key predictors for use in developing models predicting stillbirth include age, prior pregnancy outcome and PAPP-A, PLGF and Uterine artery Doppler.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/145550