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Statistics Canada data indicates that between 2002 and 2006, the late stillbirth incidence (at or beyond 28 weeks gestation) was 3.0/1000 and 4.0/1000 among Canadian and Saskatchewan births respectively. This difference questions the characteristics and associations of late losses in our province; this work aims to assess late Saskatchewan stillbirths in regard to incidence, causes, characteristics, and area-level factors. Accessing Vital Statistics cases (1987 to 2007, n=1119), descriptive statistics and incidence were examined utilizing Chi-square testing and Poisson regression. Associations between variables were evaluated by log-linear models. Area-level factors relating to incidence within census divisions were explored using Poisson regression. Although some variation existed by time and region, women were most often less than 35 years, of moderate parity, non-Aboriginal, had no previous stillbirths, and were not carrying multiple fetuses. Approximately half of the losses were preterm and half were inadequately grown. Incidence per 1000 births differed significantly for Saskatchewan (3.86) and Canada (3.43) with only Canada declining. Several division values were also higher than Saskatoons Division 11. Associations were seen between characteristics; most notably the combination of Aboriginality, increased maternal age, and large-for-gestational-age appeared over-represented compared to live births. Regions with higher proportions of Aboriginal preschoolers or land area with herbicide application had higher incidence (RR = 1.53 and 1.55, p-value less than 0.001). Further work is required to understand Saskatchewans lack of decline, what can be done about areas where incidence is increased, the significance of the associated characteristics as actual risk factors, and how Aboriginality and herbicide influence risk at the individual level. |
