A Retrospective Analysis of Stillbirth Epidemiology and Risk Factors Among First Nations and Non-First Nations Pregnancies in Alberta From 2000 to 2009

Objective: Using a large administrative dataset we examined stillbirth epidemiology in First Nations and non-First Nations pregnancies in Alberta, focusing on previously unexplored longitudinal trends. Methods: We undertook a retrospective analysis of de-identified data from 426 945 delivery records for the years 2000 to 2009. Age-adjusted prevalence of antepartum and intrapartum stillbirth were calculated and compared by ethnicity, as were longitudinal changes via average annual percent change analyses. Risk factors were explored via multivariable logistic regression analysis. Results: Overall age-adjusted prevalence of antepartum and intrapartum stillbirth was significantly higher (P < 0.001) in First Nations pregnancies than in non-First Nations pregnancies, and prevalence remained stable over time in both groups. Pre-existing diabetes was a strong predictor of stillbirth. Conclusion: Stillbirth prevalence remains higher in First Nations pregnancies than in non-First Nations. Improved awareness of pre-existing diabetes and effective interventions are needed in First Nations women to decrease stillbirth risk.