A Prospective Case-control Study of Asymptomatic Bacterial Infections in Clinically Unexplained Antepartum Stillbirths

Background:The cause of antepartum stillbirths is unknown in more than half of women, and infection is implicated as a cause in about onethird in developed countries, and it is unexplored in India.The primary objectives were to find out the incidence of bacterial infection and bacterial profile in clinically unexplained antepartum stillbirths and to compare the same with that of women with live births, and the secondary objective was to find out the risk factors for antepartum stillbirths.Materials and methods: This prospective case-control study comprised a study group of 106 women with unexplained antepartum stillbirths of >28 weeks of gestation and a 106-gestational-age-matched delivery control group (normal pregnant women) with live fetuses.Endocervical swabs and placental tissue were cultured, and Chlamydia trachomatis DNA was tested by PCR.Statistical analysis: SPSS Version 19 was used.Chi-squared test was used to compare the two groups.A p-value of 0.05 was considered significant.Results: Bacterial growth was present in 14% of cervical swab culture and 46% in placental tissue culture of the study group, and this was statistically significant.Escherichia coli was the most common organism, followed by Klebsiella spp., Enterobacter spp., and Pseudomonas spp. in still births.No risk factors like age, nutritional status, gravidity, or parity were associated with infections.Conclusions: Bacterial infection was common (46%) among unexplained antepartum stillbirths, and this is most evident by placental tissue culture than cervical swab culture.Escherichia coli and Klebsiella are the most common organisms.