Risk of silent inflammation in women after intrauterine fetal death versus selective termination to a singleton pregnancy – A retrospective single-center cohort study

Main Question:

Does intrauterine fetal death (IUFD) predispose women to a higher level of silent inflammation than selective termination of a singleton pregnancy (feticide)?

Methods:

In this retrospective cohort study, we examined maternal inflammatory parameters prior to delivery and compared results on C-reactive protein (CRP), neutrophils and leucocytes between women after IUFD versus feticide. Cases with apparent maternal or fetal infection were excluded.

Results:

The study cohort comprises 180 cases of IUFD between 21+0 and 41+3 gestational weeks (GW), as well as 148 feticides between 17+0 and 36+5 GW. Maternal age (mean ± SD) of women after IUFD was 31.37 ± 0.49 years and 30.67 ± 0.51 years after feticide, respectively (p = 0.33). CRP was found to be significantly higher in women after IUFD compared to feticide (1.80 ± 0.2 vs. 0.68 ± 0.06; p < 0.0001), as were the absolute neutrophil counts (7.73 ± 0.2 vs. 7.2 ± 0.17; p = 0.04). Also, leucocytes were significantly higher in women after IUFD compared to feticide (11.4 ± 0.29 vs. 9.92 ± 0.22; p < 0.0001).

Conclusion:

Whilst no correlation between fetal maceration grades and inflammatory parameters was previously found, in this study, we show that women after IUFD elicit higher values of inflammatory parameters, compared to women after feticide.