{"paper_id":"5f328d15-616f-454f-be39-099700ae2023","body_text":"Obesity and Diabetes as Main Risk Factors for Stillbirth in a Population from Northeastern Mexico | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Obesity and Diabetes as Main Risk Factors for Stillbirth in a Population from Northeastern Mexico Kiabeth Robles Espinoza, Graciela Arelí López Uriarte, Gloria Beatriz García Castañeda, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-647477/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose Stillbirth is an important health problem in obstetrics practice. In Mexico, half of the stillbirths have an explainable cause. The aim of this study was to detect potential stillbirth risk factors and etiology by implementing a multidisciplinary workup at the Hospital Universitario “Dr. José Eleuterio González”. Methods This is a prospective, descriptive, observational study that included stillbirths from the Obstetrics Service from October 1st, 2019 to May 25, 2020. Evaluation strategies included a complete maternal medical history, physical examination of the fetus, and a photographic medical record. A stillbirth needed to have either a prenatal ultrasound, or a postnatal x-ray, and if possible, a fetal autopsy. Multiplex Ligation Probe Amplification (MLPA) was performed with an umbilical cord sample. Results Thirty-three stillbirths were reported; 21 were included in the analysis. Eleven mothers (52.3%) had known risk factors for stillbirth, mainly elevated body mass index and diabetes. On physical examination, external birth defects were found in 8 fetuses (38%). X-ray was performed in 14 cases (66%). Alterations were detected as a probable etiologic cause just in one. All cases underwent MLPA, which were reported negative. Three cases had criteria for autopsy. Findings were inconclusive to determine etiology. Conclusion Diabetes and obesity were the most frequent risk factors associated with stillbirth in this Mexican population. These factors are preventable by implementing strategies that lead to better prenatal care. Obstetrics & Gynecology Stillbirth risk factor obesity diabetes Declarations Funding The project was funded with resources of the Genetics Department as well as the Radiology and Pathology Departments of the Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León. Conflicts of interest The authors declare that they have no conflicts of interest. Availability of data and material Data are available upon reasonable request Code availability Not applicable Author Contributions K Robles-Espinoza: Project development, sample collection, patient evaluation, data collection, tissue processing, data analysis, manuscript writing. GA López-Uriarte: Project development, data analysis, manuscript writing/editing. GB García-Castañeda: Tissue processing. I Torres-Muñoz: Tissue processing and analysis. JJ Lugo-Trampe: Tissue processing and analysis. G Elizondo-Riojas: Project development O Barbosa-Quintana: Project Development M Ponce-Camacho: Project Development A Guzmán-López: Project Development L Martinez de Villareal: Project development, data analysis, manuscript writing/editing. Ethics Approval The study was approved by the Ethics Committee of the Facultad de Medicina and Hospital Universitario, Universidad Autónoma de Nuevo León with registration number GN19-00004. Consent to participate: Participants provided written consents for participation, use and storage of tissue samples. Consent for publication: Participants provided written consent explaining protocol and usage of data for publication. Introduction Stillbirth is defined by the World Health Organization (WHO) as “death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy.” According to gestational age, it is considered a fetus of 22 weeks or that has reached a weight of 0.5 kilograms [1]. It is a devastating problem in obstetrics for families, society, and public health. It accounts for two-thirds of perinatal mortality [2]. Stillbirth occurs in 3 to 5 of every 1000 births [3]; however, these numbers might be underestimated because of inadequate registry in some countries and a lack of consensus in its classification and definition [4]. Developing countries report a higher incidence. Regions of Africa and Asia report an incidence of 28.7 and 25.5 for every 1000 births, respectively [5]. Stillbirth causes have been classified into different categories: maternal factors, fetal factors, or a combination of both. Suspected causes of stillbirth include genetic abnormalities, infection, fetal-maternal hemorrhage, and various medical conditions in the mother such as obesity, advanced maternal age, smoking, diabetes, hypertension, lupus, and thyroid diseases. Birth defects of chromosomal, monogenic, or multifactorial etiology have been described among the fetal factors. Combined factors include placental and umbilical cord pathologies [3,6,7]. It is difficult to be certain of the stillbirth etiology for several reasons. More than one cause may be involved, or some conditions might be associated but not directly causal. It is important to distinguish conditions that are mainly associations rather than causes [8]. An adequate workup for stillbirth has not been implemented. A lack of registry, consensus, comprehension about etiology, and ethical and emotional implications of some procedures might account for the absence of global stillbirth guidelines [8]. In general, a complete evaluation should have as a goal effective procedures to determine the cause and identify conditions that might be prevented. The use of a systematic evaluation, including postmortem examination, placental pathology, medical record abstraction, and maternal interview, has a higher potential of determining a true cause, as has been reported in some centers with an efficacy of 25 to 90% [2,8]. In Mexico, as in many other countries, half of the stillbirths have no explicable cause. Implementing a multidisciplinary workup that includes a complete clinical record, physical examination, autopsy, plain x-ray, cytogenetic or molecular studies permits adequate evaluation and the possibility of reaching an etiologic diagnosis, allowing the development of prevention strategies, and providing families with adequate genetic counseling [3, 7, 9, 10]. This study aimed to implement a multidisciplinary workup to identify the etiology and potential risk factors for stillbirth at a tertiary-care university hospital in Northeast Mexico. Methods This was a descriptive, observational prospective study of stillbirths from the Obstetrics Service of the Hospital Universitario “Dr. José Eleuterio González” from October 1, 2019, to May 25, 2020. Cases were collected by a resident of the Genetics Department who verified the inclusion criteria and obtained informed consent from the mother. The Ethics Committee of the Facultad de Medicina and Hospital Universitario of the Universidad Autonoma de Nuevo Leon approved the study. Stillbirths of 22 weeks or more (early and late fetal deaths) with a fetus weight > 0.5 kilograms from adult mothers were included in the study. All participant mothers provided written informed consent for participation and use of biological material for further analysis. A Genetics department resident obtained the mother´s complete medical history. After birth, a physical examination was performed on the stillborn, and a photographic record was obtained as part of every patients´ file. If the parents consented and pathology requirements were fulfilled, an autopsy was performed. The autopsy requirements were a period less than six hours from fetus extraction to the autopsy, a copy of the stillbirth certificate performed by the obstetrician, and a summary from the geneticist pinpointing the most important findings of the medical history, physical examination, and suspected diagnosis. If any of these was not achieved, a plain x-ray was used as an alternate study. Fetuses with any of the procedures mentioned before or maceration grades IV and V (stillbirth scale) [11] were excluded. Inadequate or contaminated biological samples were eliminated. Procedure Cases needed to have an autopsy, a prenatal ultrasound, or a postnatal plain x-ray. Molecular studies were performed in all cases. A 1-cm tissue sample from the umbilical cord was obtained for DNA extraction using the Gentra Puregene DNA extraction kit. This sample was used to perform Multiplex Ligation Probe Amplification (MLPA) (SALSA MLPA Probemix P095 Aneuploidy, MRC Holland), which detects DNA sequences, and has probes for chromosomes X, Y, 13, 18, and 21. The data obtained were analyzed using quantitative and qualitative statistics to calculate mean, median, and range. Probable associations were evaluated for each case. SPSS v21 was used for statistical analysis. Results Thirty-three stillbirth cases were reported at the “Dr. José Eleuterio González” University Hospital from October 2019 to May 2020, with a frequency of 7/1000 live births; of these, only 21 fulfilled the inclusion criteria. Six were lost due to delayed notification, three mothers were less than 18-years-old, two decided not to participate, and one was eliminated due to extreme maceration. The maternal demographic characteristics are shown in Table 1. The maternal age range was 18 to 38 years (median = 25 years); three were older than 35. Eleven mothers (52.3%) had known risk factors for stillbirth; some had more than one. Four mothers (19%) had pregestational diabetes with poor metabolic control before and during pregnancy. Overweight and obesity were found in 12 (57 %) women. Three (25%) were overweight (BMI = 25-29) and 9 (75%) were obese (BMI> 30). None of the mothers had preconceptional folic acid intake. Two were twin pregnancies. In both, the second baby was born without complications. None of the families participating had the antecedent of stillbirth. One had two previous abortions at five and eight weeks of gestation. Of the stillbirths included in our study, 10 were a first pregnancy (47.6%); 14 (66.6%) occurred between 29 and 37 weeks of gestation. Pregnancy ended by vaginal delivery in 18 cases (85.7%). Twelve of the stillbirths were female (57%), and 9 (42.8%) male. The stillbirths’ weight was predominantly >1000 grams (62%), and none of the stillbirths had low weight for gestational age. The degree of maceration was important for inclusion and physical examination. This evaluation was adequately performed in most cases since 76.1% presented grade I maceration. The demographics of the stillbirths are shown in Table 2. Seventeen mothers (81%) had a prenatal ultrasound; nine (53%) reported abnormalities (Table 3). External birth defects were found in 8 fetuses (38%) on physical examination; 5 had multiple malformations, 1 anencephaly, and 2 pes valgus deformity (Table 3). At initial evaluation, chromosomal alterations were suspected in two patients, and in another, a monogenic syndrome was considered. X-ray was performed in 14 cases (66%). Alterations were detected in one as a probable etiologic cause, finding pathognomonic signs of congenital syphilis. All cases underwent MLPA, which was reported negative. Conventional cytogenetics was performed in 18 patients with an umbilical cord sample. Three had adequate cell growth and yielded normal results. Only three cases had criteria for autopsy; nevertheless, the findings were inconclusive for determining the cause of stillbirth. Discussion Although the stillbirth rate has declined in recent years, it is still an important obstetric health problem due to its association with increased perinatal mortality. Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten times higher than in high-income countries. In our study, the rate of fetal deaths was 7/1000, which is lower than the mean for Latin American countries (in 2015 rate was 8.1 per 1000 births, range 3.1-24.9) but is close to Mexico’s average rate of 7.9/1000 [5]. However, problems in the notification of stillbirth and the study’s duration could influence our incidence. A long-term evaluation should be performed for more accurate data. Nevertheless, it represents a public health issue for which identifying risk factors is important to propose prevention strategies. From the major causes of stillbirths, we can point out the following: childbirth complications, multiple pregnancies, post-term pregnancy, maternal infections (malaria, syphilis, and HIV), maternal disorders (especially hypertension, obesity, and diabetes), fetal growth restriction, and congenital abnormalities. Several algorithms have been proposed for the study of stillbirth to identify possible causes of this fatal outcome of pregnancy. In this multidisciplinary workup, we used different tools. The maternal medical history, physical examination, photographs, medical record, prenatal ultrasound, x-ray, or autopsy were obtained. MLPA was performed in all cases. The correlation between maternal medical history and the description of birth defects in the fetus gave us information for possible risk factors in 16 cases, representing a usefulness of 76%, higher than 26% reported by Pauli et al. [6] and Wojcik [9]. External physical examination is important for the detection of birth defects. This procedure must be performed by a medical professional who has been trained in dysmorphology. Nevertheless, the maceration grade should be between 0 and III to facilitate the examination [11]. This approach let us identify malformations in 8 cases. Macroscopic evaluation should complement an autopsy which is considered the most useful study for stillbirth since it allows identifying characteristics not observable by physical examination. A complete autopsy should include an analysis of the placenta and umbilical cord [8,9,11]. It can identify stillbirth etiology in about 90% of cases [9]. However, to maximize the autopsy’s efficacy, it is important to consider the time from fetal death to the autopsy. The longer it takes to perform the autopsy, the less efficient it will be [9,14]. In our workup, only three autopsies were accomplished. The rest could not be achieved due to delayed notification, and in two cases, the mothers did not consent to the autopsy. It was difficult to assess the efficiency of the autopsy in our study with the data obtained, but the shortage of information obtained in those three cases may relate to a prolonged time from fetal death to evaluation. Approximately 3% of prenatal ultrasounds detect an abnormality. This can range from minor to multiple defects, which can put the development of the fetus at risk [12]. The detection of anomalies in prenatal ultrasound can affect the pregnancy outcome, so it should be considered a part of the prenatal care of all women [13]. In the present study, 17 (53 %) women had a prenatal ultrasound, of which 9 (53%) showed either fetal or placental findings of relevance for diagnosis, such as holoprosencephaly, anencephaly, hydrops fetalis, and placenta previa. The efficiency of prenatal ultrasound for detecting birth defects has been reported as 3% [12], with our rate of detection being higher. A plain X-ray is also considered an adequate study when an autopsy cannot be performed [9]. It can identify stillbirth etiology in about 16% [6]. However, a plain X-ray might be more efficient when skeletal pathology is suspected. We only detected suggestive findings in one patient (4.8%) with congenital syphilis. Genetic etiology of stillbirth can be found in 25-35% [2,9], and 6 to 12% are chromosomal alterations [8]. Conventional genetics was once considered the gold standard for stillbirth evaluation [3,11,15,16,17]. We decided to perform MLPA containing probes for chromosomes X, Y,13,18 and 21, to evaluate the most common chromosomal causes of stillbirth, which were not the case in our study; therefore, we cannot discard other chromosomal or genetic etiology. Chromosomal microarrays (CMA) are now considered the first line of study [16,17]. Maternal obesity (BMI > 30 Kg/m 2 ), has been positively associated with stillbirth [18]; however, no BMI score has been reported as secure or protective for stillbirth. In a meta-analysis by Aune et al., 18 cohorts were included to analyze BMI and stillbirth risk, finding that this association is positive for obesity and an important higher risk with a BMI of 40 [19]. In our study, 43% of the mothers had a BMI >30, which can account for the outcome of their pregnancies. Pre-gestational diabetes mellitus (DM) (either type 1 or 2) is associated with an increased risk of fetal macrosomia, birth defects, and stillbirth at 36 to 42 weeks of gestation. Similar results have been reported in gestational diabetes [20,21,22]. Fifty-seven percent of the mothers in this study had poorly controlled pre-gestational DM, which is a high proportion compared to the 5.2% reported in another study (20). The physiopathology that explains how hyperglycemia might contribute to the events that lead to fetal death has not been fully determined. Elevation of plasma lactate was reported, predominantly in the third trimester, as a possible cause [23]. This result suggests that a lactic acid elevation leads to anaerobic metabolism, causing hypoxia, acidosis, and subsequent fetal death [24]. Obesity and diabetes are serious health problems in our country, mostly in northern Mexico, and occur in 5.2% of pregnancies [20]. It is important to establish that even if diabetes or obesity is identified as an important risk factor in a woman, a complete study of stillbirth should be done because that does not eliminate the probability of other causes. Amongst maternal factors, infections account for 20% of stillbirths in developed countries [25]. Infections like cytomegalovirus and syphilis are frequently reported in these patients; usually, infectious etiology is not directly looked for; suspicion based on prenatal ultrasound or physical examination leads to its evaluation [8,25]. We identified infection risk factors by medical record data and plain X-ray. Other maternal diseases have been implicated in stillbirth like thyroid pathologies, cardiovascular, renal, rheumatic diseases, and cancer. These conditions can be associated with stillbirth in either acute or chronic states; however, most women with these conditions can achieve live births, so they are considered important for stillbirth assessment, but causality should be evaluated in every case [8]. In Mexico, one of every 90 pregnancies are twin pregnancies. These convey a higher risk of birth defects (10 times more than singleton pregnancies) [26], as well as an increased stillbirth risk, 13 times higher in monochorionic pregnancies, and 5 times higher in dichorionic pregnancies [27]. The global strategy to end stillbirth classifies twin pregnancies as an important risk factor, recommending early delivery between 34 and 37 weeks of gestation in monochorionic pregnancies and 37 to 29 in dichorionic pregnancies [27,28,29]. Prenatal care in this scenario should be stricter. Placental causes are attributed in 64.9% of stillbirths. Identification of placental pathology requires a microscopical and macroscopical evaluation after birth, prenatal markers are not considered useful for evaluation [30] Placental causes may be associated with growth restriction, but not all patients present growth restriction, and the ones that do, do not all result in stillbirth [30]. We did not perform studies on the placenta, so we cannot confirm or exclude placental etiology. Another risk factor identified in our study was tobacco consumption. Exposure to tobacco, either active or passive, has been positively identified as a stillbirth risk factor. However, when exposure is implicated, fetal growth restriction is reported, when that significant data is lacking, the risk of stillbirth has been proposed to be like women without tobacco consumption [18, 31] Conclusions We found that well-known public health problems in Mexico are present as stillbirth risk factors in our population. Diabetes and obesity are identified as the most important associations. These factors are preventable by implementing strategies that lead toward better prenatal care. The best tools for identifying stillbirth risk factors at our institution were the obtention of a medical history, physical examination, and prenatal ultrasound; however, valuable tools such as an autopsy and genetic studies should be pursued. To increase the efficacy of an autopsy, we must reduce the time from death to study. To achieve a genetic diagnosis, we should implement studies that help identify chromosomal etiologies, not only the most frequent, but also those that are not dependent on cell culture, ideally CMA. Next-Generation Sequencing (NGS) platforms are useful when a monogenic cause is suspected. By modifying these limitations, a long-term prospective study would be much informative to continue the study of stillbirth etiology. References Tavares Da Silva F, Gonik B, McMillan M et al (2016) Stillbirth: Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 34:6057–6068 Malacova E, Tippaya S, Bailey HD et al (2020) Stillbirth risk prediction using machine learning for a large cohort of births from Western Australia, 1980–2015. Scientific Reports 10 Castro DM, Castro Llamas J, González PG, Ríos MA (2012) Alteraciones genéticas y estrategias diagnósticas en muerte fetal. Ginecol Obstet Mex 80:313–319 Aminu M, Bar-Zeev S, van den Broek N (2017) Cause of and factors associated with stillbirth: a systematic review of classification systems. Acta Obstet Gynecol Scand 96:519–528 Murguía-Peniche T, Illescas-Zárate D, Chico-Barba G, Bhutta ZA (2016) An ecological study of stillbirths in Mexico from 2000 to 2013. Bull World Health Organ 94:322–330A Pauli RM, Reiser CA (1994) Wisconsin Stillbirth Service Program: II. Analysis of diagnoses and diagnostic categories in the first 1,000 referrals. Am J Med Genet 50:135–153 Holmes LB, Nasri H, Beroukhim R et al (2018) Stillborn Infants: Associated Malformations. Birth Defects Res 110:114–121 Silver RM, Varner MW, Reddy U et al (2007) Workup of stillbirth: a review of the evidence. Am J Obstet Gynecol 196:433–444 Wojcik MH, Brodsky D, Stewart JE, Picker J (2018) Peri-mortem evaluation of infants who die without a diagnosis: focus on advances in genomic technology. J Perinatol 38:1125–1134 Tomlinson AJ, Martindale E, Bancroft K, Heazell A (2018) Improved management of stillbirth using a care pathway. Int J Health Gov 23:18–37 Pinar H, Koch MA, Hawkins H et al (2012) The stillbirth collaborative research network postmortem examination protocol. Am J Perinatol 29:187–202 Lord J, McMullan DJ, Eberhardt RY et al (2019) Prenatal exome sequencing analysis in fetal structural anomalies detected by ultrasonography (PAGE): a cohort study. Lancet 393:747–757 Whitworth M, Bricker L, Mullan C (2015) Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev Man J, Hutchinson JC, Heazell AE et al (2016) Stillbirth and intrauterine fetal death: factors affecting determination of cause of death at autopsy. Ultrasound Obstet Gynecol 48:566–573 Page JM, Christiansen-Lindquist L, Thorsten V et al (2017) Diagnostic Tests for Evaluation of Stillbirth: Results From the Stillbirth Collaborative Research Network. Obstet Gynecol 129:699–706 Reddy UM, Page GP, Saade GR et al (2012) Karyotype versus microarray testing for genetic abnormalities after stillbirth. N Engl J Med 367:2185–2193 Rosenfeld JA, Tucker ME, Escobar LF et al (2015) Diagnostic utility of microarray testing in pregnancy loss. Ultrasound Obstet Gynecol 46:478–486 Gardosi J, Madurasinghe V, Williams M et al (2013) Maternal and fetal risk factors for stillbirth: population based study. BMJ 346:f108–f108 Aune D, Saugstad OD, Henriksen T, Tonstad S (2014) Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA 311:1536–1546 Tennant PWG, Glinianaia SV, Bilous RW et al (2014) Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia 57:285–294 Rosenstein MG, Cheng YW, Snowden JM et al (2012) The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol 206:309.e1–309.e7 Stacey T, Tennant P (2019) Authors’ reply re: Gestational diabetes and the risk of late stillbirth: a case–control study from England. UK BJOG 126:1184–1184 Bradley RJ, Brudenell JM, Nicolaides KH (1991) Fetal acidosis and hyperlacticaemia diagnosed by cordocentesis in pregnancies complicated by maternal diabetes mellitus. Diabet Med 8:464–468 Dudley DJ (2007) Diabetic-associated stillbirth: incidence, pathophysiology, and prevention. Clin Perinatol 34:611–626, vii Page JM, Bardsley T, Thorsten V et al (2019) Stillbirth associated with infection in a diverse US cohort. Obstetrics Gynecology 134:1187–1196 López-Uriarte A, Aguinaga-Ríos M (2012) Discordancia de defectos congénitos en recién nacidos de embarazos múltiples en el Instituto Nacional de Perinatología. Perinatol Reprod Hum 26:08–16 Cheong-See F, Schuit E, Arroyo-Manzano D et al (2016) Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis. BMJ 354:i4353 American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine (2014) ACOG Practice Bulletin No. 144: Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol 123:1118–1132 Visintin C, Mugglestone MA, James D et al (2011) Antenatal care for twin and triplet pregnancies: summary of NICE guidance. BMJ 343:d5714–d5714 Bukowski R, Hansen NI, Pinar H et al (2017) Altered fetal growth, placental abnormalities, and stillbirth. PLoS One 12:e0182874 Flenady V, Koopmans L, Middleton P et al (2011) Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 377:1331–1340 Tables Table 1. Maternal socio-demographic characteristics Characteristic Value Age range, yrs (median) 18-38 (25) Substance abuse † (%) 5/21(23.8) Smoking 4/5 (80) Alcohol 3/5 (60) Illegal drugs 1/5 (20) Maternal diseases †† (%) 9/21 (43) Diabetes mellitus 4/9 (44.4) Syphilis 2/9 (22.2) HIV 1/9 (11.1) Polycystic ovary syndrome 1/9 (11.1) Acute pancreatitis 1/9 (11.1) Colon cancer 1/9 (11.1) Elevated antepartum BMI 12/21 (57) Overweight (≥ 25 <30 kg/m 2 ) 3/12 (25) Obese (>30 kg/m 2 ) 9/12 (75) † Two patients consumed more than one substance. † † One patient had two diseases Table 2. Stillbirth demographic characteristics Characteristic n (%) Gestation number Primigravida 10 (47.6) Second to third 6 (28.5) More than 3 5 (23.8) Weeks of gestation 22 to 28 4 (19) 29 to 37 14 (66.6) More than 37 3 (14.2) Type of delivery Vaginal 18 (85.7) C-section 3 (14.2) Gender Female 12 (57) Male 9 (42.8) Weight 500-999 g 8 (38) 1000-1999 g 6 (28.5) 2000-2499 g 1 (4.7) >2500 g 6 (28.5) Degree of fetal maceration Grade 0 1 (4.7) Grade I 16 (76.1) Grade II 2 (9.5) Grade III 2 (9.5) Table 3. Summary of stillbirths with birth defects and twin pregnancies, with risk factors of importance Patient Gender Weeks Prenatal ultrasound Fetal Dysmorphology X-ray Autopsy MLPA Maternal/Fetal risk factors 1 Female 33 Alobar holoprosencephaly, parietal meningocele, perimembranous ventricular septal defect, cleft lip and palate, single umbilical artery Upslanted palpebral fissures, right cleft lip and palate, right degree 2 microtia, aplasia cutis in scalp, single umbilical artery Not performed Not performed Normal Mother with type 2 pregestational diabetes with poor metabolic control 2 Male 29 Normal Normal Not performed Not performed Normal Mother with colon cancer diagnosed at second trimester; treated with rifampicin, oxaliplatin and 5-fluorouracil; cancer lead to maternal death 3 Female 31 Not performed Normal Normal Not performed Normal Mother with polycystic ovary syndrome 4 Female 22.6 Not performed Normal Normal Not performed Normal Mother with type 2 pregestational diabetes with poor metabolic control 5 Male 30 Anencephaly Anencephaly Normal Not performed Normal Maternal Obesity 6 Male 30.1 Hydrops fetalis Ascites Normal Not performed Normal Hydrops fetalis 7 Female 34.1 Normal Normal Normal Not performed Normal None identified 8 Female 34.2 Hyperechogenic bowel, scalp, and abdominal wall edema Normal Congenital syphilis bone lesions Not performed Normal Mother with overweight, HIV and syphilis. 9 Male 27.3 Cleft lip and palate, holoprosencephaly, polydactyly Upslanted palpebral fissures, depressed nasal bridge, central cleft lip and palate, left preauricular tags, left upper extremity preaxial polydactyly Not performed Alobar holoprosencephaly, immature organs, cause of death: malformations incompatible with life. Normal Mother with pregestational type 1 diabetes 10 Male 31 Not performed Normal Normal Not performed Normal Mother with overweight and syphilis 11 Female 39 Normal Normal Normal Not performed Normal Maternal obesity 12 Female 32 Intrauterine growth restriction since week 22 nd Bilateral pes varus Not performed Not performed Normal Twin pregnancy 13 Male 33 Normal Terminal transverse limb defect in left upper extremity Not performed Acute chorioamnionitis, acute thymic involution, immature organs, advanced autolysis Normal Maternal obesity and pregestational type 2 diabetes with poor metabolic control 14 Male 34 Not performed Normal Normal Not performed Normal Maternal overweight, twin pregnancy 15 Female 30 Normal Normal Normal Not performed Normal Maternal obesity, acute pancreatitis that required surgical intervention 16 Female 22.1 Normal Normal Normal Not performed Normal Maternal obesity, advanced maternal age 17 Female 29 Complete placenta previa Normal Normal Not performed Normal Maternal obesity, advanced maternal age, placenta previa 18 Female 32 Oligohydramnios, double nuchal cord Normal Normal Not performed Normal Maternal obesity, oligohydramnios, nuchal cord 19 Male 29 Frontoparietal bilateral porencephaly, intracranial hemorrhage (grade I), microcephaly, corpus callosum hypoplasia, cerebellar vermis hypoplasia, small for gestational age, hyperechogenic bowel, oligohydramnios. Hypertelorism, pterygium in elbows, knees, and feet Normal Massive autolysis Normal No risk factor, monogenic cause suspected, probable lethal multiple pterygium syndrome 20 Male 35.1 Normal Bilateral pes varus Not performed Not authorized Normal Maternal obesity, fetus with weight above 90 th percentile 21 Female 38 Normal Normal Not performed Not authorized Normal Maternal obesity, fetus with weight above 90 th percentile Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-647477\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":39668729,\"identity\":\"b0849150-c155-4170-a503-43c6d407ef6a\",\"order_by\":0,\"name\":\"Kiabeth Robles Espinoza\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIiWNgGAWjYBACCWYGNiB1gIGBvQFIG1gQqyUBqIXnAEiLBBFaGGBaJBKgfEJAsp352YOPP+7k80s+v7rhR4EEA397dwJeLdLMbOaGMxKeWc6cnVN2swfoMIkzZzfg1SLHzGAmzZNw2MDgdk7aDR6gFgOJXEJa2L9J/wFqsb95Ju3mH2K0SDPzmEkzgGyRYD92myhbJJt5yg170g4bSJzJYbstYyDBQ9AvEuePb3vww+awAX/78Wc33/yxkeNv78WvBQnwGIBJYpWDAPsDUlSPglEwCkbBCAIA+XpE+caaIV8AAAAASUVORK5CYII=\",\"orcid\":\"https://orcid.org/0000-0002-1036-3249\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":true,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Kiabeth\",\"middleName\":\"Robles\",\"lastName\":\"Espinoza\",\"suffix\":\"\"},{\"id\":39668730,\"identity\":\"94f0905a-af4a-4e3a-b1f9-5f6795a8884d\",\"order_by\":1,\"name\":\"Graciela Arelí López Uriarte\",\"email\":\"\",\"orcid\":\"https://orcid.org/0000-0001-8562-0847\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Graciela\",\"middleName\":\"Arelí López\",\"lastName\":\"Uriarte\",\"suffix\":\"\"},{\"id\":39668731,\"identity\":\"5f0694fd-de36-4d22-96b4-c11b7bffd2ae\",\"order_by\":2,\"name\":\"Gloria Beatriz García Castañeda\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Gloria\",\"middleName\":\"Beatriz García\",\"lastName\":\"Castañeda\",\"suffix\":\"\"},{\"id\":39668732,\"identity\":\"6026b20a-9515-48de-a98f-c0a707bd7f93\",\"order_by\":3,\"name\":\"Iris Torres Muñoz\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Iris\",\"middleName\":\"Torres\",\"lastName\":\"Muñoz\",\"suffix\":\"\"},{\"id\":39668733,\"identity\":\"628922b4-3ca7-479d-a28d-689b9a867a62\",\"order_by\":4,\"name\":\"José de Jesús Lugo Trampe\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"José\",\"middleName\":\"de Jesús Lugo\",\"lastName\":\"Trampe\",\"suffix\":\"\"},{\"id\":39668734,\"identity\":\"e62893d0-175d-4f30-a474-87a13a551bef\",\"order_by\":5,\"name\":\"Guillermo Elizondo Riojas\",\"email\":\"\",\"orcid\":\"https://orcid.org/0000-0002-9555-430X\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Guillermo\",\"middleName\":\"Elizondo\",\"lastName\":\"Riojas\",\"suffix\":\"\"},{\"id\":39668735,\"identity\":\"a532a8ac-5894-4b41-8392-6f84c5df6635\",\"order_by\":6,\"name\":\"Oralia Barboza Quintana\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Oralia\",\"middleName\":\"Barboza\",\"lastName\":\"Quintana\",\"suffix\":\"\"},{\"id\":39668736,\"identity\":\"50764e67-f66a-4117-ba6f-fb4fb26d2d9e\",\"order_by\":7,\"name\":\"Marco Ponce Camacho\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Marco\",\"middleName\":\"Ponce\",\"lastName\":\"Camacho\",\"suffix\":\"\"},{\"id\":39668737,\"identity\":\"8ff8717a-47de-4b5b-88b7-312c18f4e8d5\",\"order_by\":8,\"name\":\"Abel Guzmán López\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Abel\",\"middleName\":\"Guzmán\",\"lastName\":\"López\",\"suffix\":\"\"},{\"id\":39668738,\"identity\":\"42551e75-e84e-4d91-befe-8415919a0765\",\"order_by\":9,\"name\":\"Laura Martínez de Villareal\",\"email\":\"\",\"orcid\":\"https://orcid.org/0000-0003-1442-9089\",\"institution\":\"Hospital Universitario Dr Jose Eleuterio Gonzalez\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Laura\",\"middleName\":\"Martínez\",\"lastName\":\"de Villareal\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2021-06-22 20:26:37\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-647477/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-647477/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":13705016,\"identity\":\"3018ec60-4a41-4736-8375-213bd427ad05\",\"added_by\":\"auto\",\"created_at\":\"2021-09-17 13:49:15\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":316280,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-647477/v1/b7e06b3b-3ebc-44c3-a734-cfadeb892c5d.pdf\"}],\"financialInterests\":\"\",\"formattedTitle\":\"Obesity and Diabetes as Main Risk Factors for Stillbirth in a Population from Northeastern Mexico\",\"fulltext\":[{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe project was funded with resources of the Genetics Department as well as the Radiology and Pathology Departments of the Hospital Universitario \\u0026ldquo;Dr. Jos\\u0026eacute; Eleuterio Gonz\\u0026aacute;lez,\\u0026rdquo; Universidad Aut\\u0026oacute;noma de Nuevo Le\\u0026oacute;n.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflicts of interest\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that they have no conflicts of interest.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of data and material\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eData are available upon reasonable request\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCode availability\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eK Robles-Espinoza: Project development, sample collection, patient evaluation, data collection, tissue processing, data analysis, manuscript writing.\\u003c/p\\u003e\\n\\u003cp\\u003eGA L\\u0026oacute;pez-Uriarte: Project development, data analysis, manuscript writing/editing.\\u003c/p\\u003e\\n\\u003cp\\u003eGB Garc\\u0026iacute;a-Casta\\u0026ntilde;eda: Tissue processing.\\u003c/p\\u003e\\n\\u003cp\\u003eI Torres-Mu\\u0026ntilde;oz: Tissue processing and analysis.\\u003c/p\\u003e\\n\\u003cp\\u003eJJ Lugo-Trampe: Tissue processing and analysis.\\u003c/p\\u003e\\n\\u003cp\\u003eG Elizondo-Riojas: Project development\\u003c/p\\u003e\\n\\u003cp\\u003eO Barbosa-Quintana: Project Development\\u003c/p\\u003e\\n\\u003cp\\u003eM Ponce-Camacho: Project Development\\u003c/p\\u003e\\n\\u003cp\\u003eA Guzm\\u0026aacute;n-L\\u0026oacute;pez: Project Development\\u003c/p\\u003e\\n\\u003cp\\u003eL Martinez de Villareal: Project development, data analysis, manuscript writing/editing.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthics Approval\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe study was approved by the Ethics Committee of the Facultad de Medicina and Hospital Universitario, Universidad Aut\\u0026oacute;noma de Nuevo Le\\u0026oacute;n with registration number GN19-00004.\\u003c/p\\u003e\\n\\u003cp\\u003eConsent to participate: Participants provided written consents for participation, use and storage of tissue samples.\\u003c/p\\u003e\\n\\u003cp\\u003eConsent for publication: Participants provided written consent explaining protocol and usage of data for publication.\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eStillbirth is defined by the World Health Organization (WHO) as \\u0026ldquo;death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy.\\u0026rdquo; According to gestational age, it is considered a fetus of 22 weeks or that has reached a weight of 0.5 kilograms [1].\\u0026nbsp;It is a devastating problem in obstetrics for families, society, and public health. It accounts for two-thirds of perinatal mortality [2].\\u003c/p\\u003e\\n\\u003cp\\u003eStillbirth occurs in 3 to 5 of every 1000 births [3]; however, these numbers might be underestimated because of inadequate registry in some countries and a lack of consensus in its classification and definition [4]. Developing countries report a higher incidence. Regions of Africa and Asia report an incidence of 28.7 and 25.5 for every 1000 births, respectively [5].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eStillbirth causes have been classified into different categories: maternal factors, fetal factors, or a combination of both.\\u0026nbsp;Suspected causes of stillbirth include genetic abnormalities, infection, fetal-maternal hemorrhage, and various medical conditions in the mother such as\\u0026nbsp;obesity, advanced maternal age, smoking, diabetes, hypertension, lupus, and thyroid diseases. Birth defects of chromosomal, monogenic, or multifactorial etiology have been described among the fetal factors. Combined factors include placental and umbilical cord pathologies [3,6,7].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eIt is difficult to be certain of the stillbirth etiology for several reasons. More than one cause may be involved, or some conditions might be associated but not directly causal. It is important to distinguish conditions that are mainly associations rather than causes [8]. An adequate workup for stillbirth has not been implemented. A lack of registry, consensus, comprehension about etiology, and ethical and emotional implications of some procedures might account for the absence of global stillbirth guidelines [8].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eIn general, a complete evaluation should have as a goal effective procedures to determine the cause and identify conditions that might be prevented. The use of a systematic evaluation,\\u0026nbsp;including postmortem examination, placental pathology, medical record abstraction, and maternal interview, has a higher potential of determining a true cause, as has been reported in some centers with an efficacy of 25 to 90% [2,8].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eIn Mexico, as in many other countries, half of the stillbirths have no explicable cause. Implementing a multidisciplinary workup that includes a complete clinical record, physical examination, autopsy, plain x-ray, cytogenetic or molecular studies permits adequate evaluation and the possibility of reaching an etiologic diagnosis, allowing the development of prevention strategies, and providing families with adequate genetic counseling [3, 7, 9, 10].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThis study aimed to implement a multidisciplinary workup to identify the etiology and potential risk factors for stillbirth at a tertiary-care university hospital in Northeast Mexico.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cp\\u003eThis was a descriptive, observational prospective study of stillbirths from the Obstetrics Service of the Hospital Universitario \\u0026ldquo;Dr. Jos\\u0026eacute; Eleuterio Gonz\\u0026aacute;lez\\u0026rdquo; from October 1, 2019, to May 25, 2020. Cases were collected by a resident of the Genetics Department who verified the inclusion criteria and obtained informed consent from the mother. The Ethics Committee of the Facultad de Medicina and Hospital Universitario of the Universidad Autonoma de Nuevo Leon approved the study.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eStillbirths of 22 weeks or more (early and late fetal deaths) with a fetus weight \\u003cu\\u003e\\u0026gt;\\u003c/u\\u003e 0.5 kilograms from adult mothers were included in the study. All participant mothers provided written informed consent for participation and use of biological material for further analysis. A Genetics department resident obtained the mother\\u0026acute;s complete medical history. \\u0026nbsp;After birth, a physical examination was performed on the stillborn, and a photographic record was obtained as part of every patients\\u0026acute; file. If the parents consented and pathology requirements were fulfilled, an autopsy was performed.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThe autopsy requirements were a period less than six hours from fetus extraction to the autopsy, a copy of the stillbirth certificate performed by the obstetrician, and a summary from the geneticist pinpointing the most important findings of the medical history, physical examination, and suspected diagnosis. If any of these was not achieved, a plain x-ray was used as an alternate study.\\u003c/p\\u003e\\n\\u003cp\\u003eFetuses with any of the procedures mentioned before or maceration grades IV and V (stillbirth scale) [11] were excluded. Inadequate or contaminated biological samples were eliminated.\\u003c/p\\u003e\\n\\u003cp\\u003eProcedure\\u003c/p\\u003e\\n\\u003cp\\u003eCases needed to have an autopsy, a prenatal ultrasound, or a postnatal plain x-ray. Molecular studies were performed in all cases. A 1-cm tissue sample from the umbilical cord was obtained for DNA extraction using the Gentra Puregene DNA extraction kit. This sample was used to perform Multiplex Ligation Probe Amplification (MLPA) (SALSA MLPA Probemix P095 Aneuploidy, MRC Holland), which detects DNA sequences, and has probes for chromosomes X, Y, 13, 18, and 21.\\u003c/p\\u003e\\n\\u003cp\\u003eThe data obtained were analyzed using quantitative and qualitative statistics to calculate mean, median, and range. Probable associations were evaluated for each case. SPSS v21 was used for statistical analysis.\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThirty-three stillbirth cases were reported at the \\u0026ldquo;Dr. Jos\\u0026eacute; Eleuterio Gonz\\u0026aacute;lez\\u0026rdquo; University Hospital from October 2019 to May 2020, with a frequency of 7/1000 live births; of these, only 21 fulfilled the inclusion criteria. Six were lost due to delayed notification, three mothers were less than 18-years-old, two decided not to participate, and one was eliminated due to extreme maceration.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThe maternal demographic characteristics are shown in Table 1. \\u0026nbsp;The maternal age range was 18 to 38 years (median = 25 years); three were older than 35. Eleven mothers (52.3%) had known risk factors for stillbirth; some had more than one. Four mothers (19%) had pregestational diabetes with poor metabolic control before and during pregnancy. Overweight and obesity were found in 12 (57 %) women. Three (25%) were overweight (BMI = 25-29) and 9 (75%) were obese (BMI\\u0026gt; 30). None of the mothers had preconceptional folic acid intake.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eTwo were twin pregnancies. In both, the second baby was born without complications. None of the families participating had the antecedent of stillbirth. One had two previous abortions at five and eight weeks of gestation.\\u003c/p\\u003e\\n\\u003cp\\u003eOf the stillbirths included in our study, 10 were a first pregnancy (47.6%); 14 (66.6%) occurred between 29 and 37 weeks of gestation. Pregnancy ended by vaginal delivery in 18 cases (85.7%). Twelve of the stillbirths were female (57%), and 9 (42.8%) male. The stillbirths\\u0026rsquo; weight was predominantly \\u0026gt;1000 grams (62%), and none of the stillbirths had low weight for gestational age. The degree of maceration was important for inclusion and physical examination. This evaluation was adequately performed in most cases since 76.1% presented grade I maceration. The demographics of the stillbirths are shown in Table 2. Seventeen mothers (81%) had a prenatal ultrasound; nine (53%) reported abnormalities (Table 3).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eExternal birth defects were found in 8 fetuses (38%) on physical examination; 5 had multiple malformations, 1 anencephaly, and 2 pes valgus deformity (Table 3). At initial evaluation, chromosomal alterations were suspected in two patients, and in another, a monogenic syndrome was considered.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;X-ray was performed in 14 cases (66%). Alterations were detected in one as a probable etiologic cause, finding pathognomonic signs of congenital syphilis.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eAll cases underwent MLPA, which was reported negative. Conventional cytogenetics was performed in 18 patients with an umbilical cord sample. Three had adequate cell growth and yielded normal results. Only three cases had criteria for autopsy; nevertheless, the findings were inconclusive for determining the cause of stillbirth.\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eAlthough the stillbirth rate has declined in recent years, it is still an important obstetric health problem due to its association with increased perinatal mortality. Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten times higher than in high-income countries.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eIn our study, the rate of fetal deaths was 7/1000, which is lower than the mean for Latin American countries (in 2015 rate was 8.1 per 1000 births, range 3.1-24.9) but is close to Mexico\\u0026rsquo;s average rate of 7.9/1000\\u0026nbsp;[5].\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003eHowever, problems in the notification of stillbirth and the study\\u0026rsquo;s duration could influence our incidence. A long-term evaluation should be performed for more accurate data. Nevertheless, it represents a public health issue for which identifying risk factors is important to propose prevention strategies.\\u003c/p\\u003e\\n\\u003cp\\u003eFrom the major causes of stillbirths, we can point out the following:\\u0026nbsp;childbirth complications, multiple pregnancies, post-term pregnancy, maternal infections (malaria, syphilis, and HIV), maternal disorders (especially hypertension, obesity, and diabetes), fetal growth restriction, and congenital abnormalities.\\u0026nbsp;Several algorithms have been proposed for the study of stillbirth to identify possible causes of this fatal outcome of pregnancy.\\u003c/p\\u003e\\n\\u003cp\\u003eIn this multidisciplinary workup, we used different tools. The maternal medical history, physical examination, photographs, medical record, prenatal ultrasound, x-ray, or autopsy were obtained. MLPA was performed in all cases.\\u003c/p\\u003e\\n\\u003cp\\u003eThe correlation between maternal medical history and the description of birth defects in the fetus gave us information for possible risk factors in 16 cases, representing a usefulness of 76%, higher than 26% reported by Pauli et al. [6] and Wojcik [9]. \\u003c/p\\u003e\\n\\u003cp\\u003eExternal physical examination is important for the detection of birth defects. This procedure must be performed by a medical professional who has been trained in dysmorphology. Nevertheless, the maceration grade should be between 0 and III to facilitate the examination [11]. This approach let us identify malformations in 8 cases. Macroscopic evaluation should complement an autopsy which is considered the most useful study for stillbirth since it allows identifying characteristics not observable by physical examination. A complete autopsy should include an analysis of the placenta and umbilical cord [8,9,11]. It can identify stillbirth etiology in about 90% of cases [9]. However, to maximize the autopsy\\u0026rsquo;s efficacy, it is important to consider the time from fetal death to the autopsy. The longer it takes to perform the autopsy, the less efficient it will be [9,14]. In our workup, only three autopsies were accomplished. The rest could not be achieved due to delayed notification, and in two cases, the mothers did not consent to the autopsy. It was difficult to assess the efficiency of the autopsy in our study with the data obtained, but the shortage of information obtained in those three cases may relate to a prolonged time from fetal death to evaluation.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eApproximately 3% of prenatal ultrasounds detect an abnormality. This can range from minor to multiple defects, which can put the development of the fetus at risk [12]. The detection of anomalies in prenatal ultrasound can affect the pregnancy outcome, so it should be considered a part of the prenatal care of all women [13]. In the present study, 17 (53 %) women had a prenatal ultrasound, of which 9 (53%) showed either fetal or placental findings of relevance for diagnosis, such as holoprosencephaly, anencephaly, hydrops fetalis, and placenta previa. The efficiency of prenatal ultrasound for detecting birth defects has been reported as 3% [12], with our rate of detection being higher.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eA plain X-ray is also considered an adequate study when an autopsy cannot be performed [9]. It can identify stillbirth etiology in about 16% [6]. However, a plain X-ray might be more efficient when skeletal pathology is suspected. We only detected suggestive findings in one patient (4.8%) with congenital syphilis.\\u003c/p\\u003e\\n\\u003cp\\u003eGenetic etiology of stillbirth can be found in 25-35% [2,9], and 6 to 12% are chromosomal alterations [8]. Conventional genetics was once considered the gold standard for stillbirth evaluation [3,11,15,16,17]. We decided to perform MLPA containing probes for chromosomes X, Y,13,18 and 21, to evaluate the most common chromosomal causes of stillbirth, which were not the case in our study; therefore, we cannot discard other chromosomal or genetic etiology. Chromosomal microarrays (CMA) are now considered the first line of study [16,17].\\u003c/p\\u003e\\n\\u003cp\\u003eMaternal obesity (BMI \\u003cu\\u003e\\u0026gt;\\u003c/u\\u003e 30 Kg/m\\u003csup\\u003e2\\u003c/sup\\u003e), has been positively associated with stillbirth [18]; however, no BMI score has been reported as secure or protective for stillbirth. In a meta-analysis by Aune et al., 18 cohorts were included to analyze BMI and stillbirth risk, finding that this association is positive for obesity and an important higher risk with a BMI of 40 [19]. In our study, 43% of the mothers had a BMI \\u0026gt;30, which can account for the outcome of their pregnancies.\\u003c/p\\u003e\\n\\u003cp\\u003ePre-gestational diabetes mellitus (DM) (either type 1 or 2) is associated with an increased risk of fetal macrosomia, birth defects, and stillbirth at 36 to 42 weeks of gestation. Similar results have been reported in gestational diabetes [20,21,22]. Fifty-seven percent of the mothers in this study had poorly controlled pre-gestational DM, which is a high proportion compared to the 5.2% reported in another study (20). The physiopathology that explains how hyperglycemia might contribute to the events that lead to fetal death has not been fully determined. Elevation of plasma lactate was reported, predominantly in the third trimester, as a possible cause [23]. This result suggests that a lactic acid elevation leads to anaerobic metabolism, causing hypoxia, acidosis, and subsequent fetal death [24]. Obesity and diabetes are serious health problems in our country, mostly in northern Mexico, and occur in 5.2% of pregnancies [20].\\u003c/p\\u003e\\n\\u003cp\\u003eIt is important to establish that even if diabetes or obesity is identified as an important risk factor in a woman, a complete study of stillbirth should be done because that does not eliminate the probability of other causes.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eAmongst maternal factors, infections account for 20% of stillbirths in developed countries [25]. Infections like cytomegalovirus and syphilis are frequently reported in these patients; usually, infectious etiology is not directly looked for; suspicion based on prenatal ultrasound or physical examination leads to its evaluation [8,25]. We identified infection risk factors by medical record data and plain X-ray.\\u003c/p\\u003e\\n\\u003cp\\u003eOther maternal diseases have been implicated in stillbirth like thyroid pathologies, cardiovascular, renal, rheumatic diseases, and cancer. These conditions can be associated with stillbirth in either acute or chronic states; however, most women with these conditions can achieve live births, so they are considered important for stillbirth assessment, but causality should be evaluated in every case [8].\\u003c/p\\u003e\\n\\u003cp\\u003eIn Mexico, one of every 90 pregnancies are twin pregnancies. These convey a higher risk of birth defects (10 times more than singleton pregnancies) [26], as well as an increased stillbirth risk, 13 times higher in monochorionic pregnancies, and 5 times higher in dichorionic pregnancies [27].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThe global strategy to end stillbirth classifies twin pregnancies as an important risk factor, recommending early delivery between 34 and 37 weeks of gestation in monochorionic pregnancies and 37 to 29 in dichorionic pregnancies [27,28,29]. Prenatal care in this scenario should be stricter.\\u003c/p\\u003e\\n\\u003cp\\u003ePlacental causes are attributed in 64.9% of stillbirths. Identification of placental pathology requires a microscopical and macroscopical evaluation after birth, prenatal markers are not considered useful for evaluation [30]\\u003c/p\\u003e\\n\\u003cp\\u003ePlacental causes may be associated with growth restriction, but not all patients present growth restriction, and the ones that do, do not all result in stillbirth [30]. We did not perform studies on the placenta, so we cannot confirm or exclude placental etiology.\\u003c/p\\u003e\\n\\u003cp\\u003eAnother risk factor identified in our study was tobacco consumption. Exposure to tobacco, either active or passive, has been positively identified as a stillbirth risk factor. However, when exposure is implicated, fetal growth restriction is reported, when that significant data is lacking, the risk of stillbirth has been proposed to be like women without tobacco consumption [18, 31]\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eWe found that well-known public health problems in Mexico are present as stillbirth risk factors in our population. Diabetes and obesity are identified as the most important associations. These factors are preventable by implementing strategies that lead toward better prenatal care.\\u003c/p\\u003e\\n\\u003cp\\u003eThe best tools for identifying stillbirth risk factors at our institution were the obtention of a medical history, physical examination, and prenatal ultrasound; however, valuable tools such as an autopsy and genetic studies should be pursued. To increase the efficacy of an autopsy, we must reduce the time from death to study. To achieve a genetic diagnosis, we should implement studies that help identify chromosomal etiologies, not only the most frequent, but also those that are not dependent on cell culture, ideally CMA. Next-Generation Sequencing (NGS) platforms are useful when a monogenic cause is suspected.\\u003c/p\\u003e\\n\\u003cp\\u003eBy modifying these limitations, a long-term prospective study would be much informative to continue the study of stillbirth etiology.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eTavares Da Silva F, Gonik B, McMillan M et al (2016) Stillbirth: Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 34:6057\\u0026ndash;6068\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMalacova E, Tippaya S, Bailey HD et al (2020) Stillbirth risk prediction using machine learning for a large cohort of births from Western Australia, 1980\\u0026ndash;2015. Scientific Reports 10\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCastro DM, Castro Llamas J, Gonz\\u0026aacute;lez PG, R\\u0026iacute;os MA (2012) Alteraciones gen\\u0026eacute;ticas y estrategias diagn\\u0026oacute;sticas en muerte fetal. Ginecol Obstet Mex 80:313\\u0026ndash;319\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAminu M, Bar-Zeev S, van den Broek N (2017) Cause of and factors associated with stillbirth: a systematic review of classification systems. Acta Obstet Gynecol Scand 96:519\\u0026ndash;528\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMurgu\\u0026iacute;a-Peniche T, Illescas-Z\\u0026aacute;rate D, Chico-Barba G, Bhutta ZA (2016) An ecological study of stillbirths in Mexico from 2000 to 2013. Bull World Health Organ 94:322\\u0026ndash;330A\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePauli RM, Reiser CA (1994) Wisconsin Stillbirth Service Program: II. Analysis of diagnoses and diagnostic categories in the first 1,000 referrals. Am J Med Genet 50:135\\u0026ndash;153\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHolmes LB, Nasri H, Beroukhim R et al (2018) Stillborn Infants: Associated Malformations. Birth Defects Res 110:114\\u0026ndash;121\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSilver RM, Varner MW, Reddy U et al (2007) Workup of stillbirth: a review of the evidence. Am J Obstet Gynecol 196:433\\u0026ndash;444\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWojcik MH, Brodsky D, Stewart JE, Picker J (2018) Peri-mortem evaluation of infants who die without a diagnosis: focus on advances in genomic technology. J Perinatol 38:1125\\u0026ndash;1134\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTomlinson AJ, Martindale E, Bancroft K, Heazell A (2018) Improved management of stillbirth using a care pathway. Int J Health Gov 23:18\\u0026ndash;37\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePinar H, Koch MA, Hawkins H et al (2012) The stillbirth collaborative research network postmortem examination protocol. Am J Perinatol 29:187\\u0026ndash;202\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLord J, McMullan DJ, Eberhardt RY et al (2019) Prenatal exome sequencing analysis in fetal structural anomalies detected by ultrasonography (PAGE): a cohort study. Lancet 393:747\\u0026ndash;757\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWhitworth M, Bricker L, Mullan C (2015) Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMan J, Hutchinson JC, Heazell AE et al (2016) Stillbirth and intrauterine fetal death: factors affecting determination of cause of death at autopsy. Ultrasound Obstet Gynecol 48:566\\u0026ndash;573\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePage JM, Christiansen-Lindquist L, Thorsten V et al (2017) Diagnostic Tests for Evaluation of Stillbirth: Results From the Stillbirth Collaborative Research Network. Obstet Gynecol 129:699\\u0026ndash;706\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eReddy UM, Page GP, Saade GR et al (2012) Karyotype versus microarray testing for genetic abnormalities after stillbirth. N Engl J Med 367:2185\\u0026ndash;2193\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRosenfeld JA, Tucker ME, Escobar LF et al (2015) Diagnostic utility of microarray testing in pregnancy loss. Ultrasound Obstet Gynecol 46:478\\u0026ndash;486\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGardosi J, Madurasinghe V, Williams M et al (2013) Maternal and fetal risk factors for stillbirth: population based study. BMJ 346:f108\\u0026ndash;f108\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAune D, Saugstad OD, Henriksen T, Tonstad S (2014) Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA 311:1536\\u0026ndash;1546\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTennant PWG, Glinianaia SV, Bilous RW et al (2014) Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia 57:285\\u0026ndash;294\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRosenstein MG, Cheng YW, Snowden JM et al (2012) The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol 206:309.e1\\u0026ndash;309.e7\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eStacey T, Tennant P (2019) Authors\\u0026rsquo; reply re: Gestational diabetes and the risk of late stillbirth: a case\\u0026ndash;control study from England. UK BJOG 126:1184\\u0026ndash;1184\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBradley RJ, Brudenell JM, Nicolaides KH (1991) Fetal acidosis and hyperlacticaemia diagnosed by cordocentesis in pregnancies complicated by maternal diabetes mellitus. Diabet Med 8:464\\u0026ndash;468\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDudley DJ (2007) Diabetic-associated stillbirth: incidence, pathophysiology, and prevention. Clin Perinatol 34:611\\u0026ndash;626, vii\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePage JM, Bardsley T, Thorsten V et al (2019) Stillbirth associated with infection in a diverse US cohort. Obstetrics Gynecology 134:1187\\u0026ndash;1196\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eL\\u0026oacute;pez-Uriarte A, Aguinaga-R\\u0026iacute;os M (2012) Discordancia de defectos cong\\u0026eacute;nitos en reci\\u0026eacute;n nacidos de embarazos m\\u0026uacute;ltiples en el Instituto Nacional de Perinatolog\\u0026iacute;a. Perinatol Reprod Hum 26:08\\u0026ndash;16\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCheong-See F, Schuit E, Arroyo-Manzano D et al (2016) Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis. BMJ 354:i4353\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAmerican College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine (2014) ACOG Practice Bulletin No. 144: Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol 123:1118\\u0026ndash;1132\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eVisintin C, Mugglestone MA, James D et al (2011) Antenatal care for twin and triplet pregnancies: summary of NICE guidance. BMJ 343:d5714\\u0026ndash;d5714\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBukowski R, Hansen NI, Pinar H et al (2017) Altered fetal growth, placental abnormalities, and stillbirth. PLoS One 12:e0182874\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFlenady V, Koopmans L, Middleton P et al (2011) Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 377:1331\\u0026ndash;1340\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"},{\"header\":\"Tables\",\"content\":\"\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eTable 1.\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal socio-demographic characteristics\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border-collapse:collapse;border:none;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eCharacteristic\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eValue\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAge range, yrs (median)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e18-38 (25)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eSubstance abuse\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;color:black;background:white;'\\u003e\\u0026dagger;\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family: \\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;(%)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e5/21(23.8)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eSmoking\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e4/5 (80)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAlcohol\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e3/5 (60)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eIllegal drugs\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1/5 (20)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal diseases\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;color:black;background:white;'\\u003e\\u0026nbsp;\\u0026dagger;\\u0026dagger;\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family: \\\"Times New Roman\\\",serif;'\\u003e(%)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e9/21 (43)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eDiabetes mellitus\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e4/9 (44.4)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eSyphilis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e2/9 (22.2)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eHIV\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1/9 (11.1)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003ePolycystic ovary syndrome\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1/9 (11.1)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAcute pancreatitis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1/9 (11.1)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eColon cancer\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1/9 (11.1)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eElevated antepartum BMI\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e12/21 (57)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eOverweight (\\u0026ge; 25 \\u0026lt;30\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family: \\\"Times New Roman\\\",serif;'\\u003ekg/m\\u003csup\\u003e2\\u003c/sup\\u003e)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e3/12 (25)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 161.35pt;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eObese (\\u0026gt;30\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003ekg/m\\u003csup\\u003e2\\u003c/sup\\u003e)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 85.05pt;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e9/12 (75)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"width: 100%\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd\\u003e\\n \\u003cdiv style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:12px;line-height:107%;font-family:\\\"Arial\\\",sans-serif;color:#424242;background:white;'\\u003e\\u0026dagger;\\u003c/span\\u003e\\u003cspan style='font-family:\\\"Arial\\\",sans-serif;color:#222222;background:white;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style=\\\"font-size:13px;line-height:107%;\\\"\\u003eTwo patients consumed more than one substance.\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style=\\\"font-size:13px;line-height:107%;\\\"\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style='font-size:12px;line-height:107%;font-family:\\\"Arial\\\",sans-serif;color:#424242;background:white;'\\u003e\\u0026dagger;\\u003c/span\\u003e\\u003cspan style='font-family: \\\"Arial\\\",sans-serif;color:#222222;background:white;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style='font-size:12px;line-height:107%;font-family:\\\"Arial\\\",sans-serif;color:#424242;background:white;'\\u003e\\u0026dagger;\\u003c/span\\u003e\\u003cspan style='font-family: \\\"Arial\\\",sans-serif;color:#222222;background:white;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003cspan style=\\\"font-size:13px;line-height:107%;\\\"\\u003eOne patient had two diseases\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eTable 2.\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;Stillbirth demographic characteristics\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border: none;width:255.15pt;margin-left:5.4pt;border-collapse:collapse;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eCharacteristic\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003en (%)\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" style=\\\"width: 255.15pt;border: medium none;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGestation number\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003ePrimigravida\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e10 (47.6)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eSecond to third\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e6 (28.5)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMore than 3\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e5 (23.8)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" style=\\\"width: 255.15pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eWeeks of gestation\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e22 to 28\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e4 (19)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e29 to 37\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;14 (66.6)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMore than 37\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e3 (14.2)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" style=\\\"width: 255.15pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eType of delivery\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eVaginal\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e18 (85.7)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eC-section\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;3 (14.2)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" style=\\\"width: 255.15pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGender\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e12 (57)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e9 (42.8)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" style=\\\"width: 255.15pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eWeight\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e500-999 g\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e8 (38)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1000-1999 g\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e6 (28.5)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e2000-2499 g\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1 (4.7)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026gt;2500 g\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e6 (28.5)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eDegree of fetal maceration\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGrade 0\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1 (4.7)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGrade I\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e16 (76.1)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGrade II\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e2 (9.5)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 126.1pt;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGrade III\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 129.05pt;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0.75pt 5.4pt 0in;height: 28.35pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e2 (9.5)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eTable 3.\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eSummary of stillbirths with birth defects and twin pregnancies, with risk factors of importance\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border: none;width:101.46%;margin-left:-1.7pt;border-collapse:collapse;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003ePatient\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eGender\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eWeeks\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003ePrenatal ultrasound\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFetal Dysmorphology\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eX-ray\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAutopsy\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMLPA\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;border-color: windowtext currentcolor;border-style: solid none;border-width: 1pt medium;padding: 0in 5.4pt;height: 11.9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal/Fetal risk factors\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e33\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAlobar holoprosencephaly, parietal meningocele, perimembranous ventricular septal defect, cleft lip and palate, single umbilical artery\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eUpslanted palpebral fissures, right cleft lip and palate, right degree 2 microtia, aplasia cutis in scalp, single umbilical artery\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;border: medium none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with type 2 pregestational diabetes with poor metabolic control\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e2\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e29\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with colon cancer diagnosed at second trimester; treated with rifampicin, oxaliplatin and 5-fluorouracil; cancer lead to maternal death\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e3\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e31\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with polycystic ovary syndrome\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e4\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e22.6\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with type 2 pregestational diabetes with poor metabolic control\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e5\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e30\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAnencephaly\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAnencephaly\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal Obesity\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e6\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e30.1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eHydrops fetalis\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAscites\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eHydrops fetalis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e7\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e34.1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNone identified\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e8\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e34.2\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eHyperechogenic bowel, scalp, and abdominal wall edema\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eCongenital syphilis bone lesions\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with overweight, HIV and syphilis.\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e9\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e27.3\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eCleft lip and palate, holoprosencephaly, polydactyly\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eUpslanted palpebral fissures, depressed nasal bridge, central cleft lip and palate, left preauricular tags, left upper extremity preaxial polydactyly\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAlobar holoprosencephaly, immature organs, cause of death: malformations incompatible with life.\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with pregestational type 1 diabetes\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e10\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e31\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMother with overweight and syphilis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e11\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e39\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e12\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e32\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eIntrauterine growth restriction since week 22\\u003csup\\u003end\\u003c/sup\\u003e\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eBilateral pes varus\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eTwin pregnancy\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e13\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e33\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eTerminal transverse limb defect in left upper extremity\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eAcute chorioamnionitis, acute thymic involution, immature organs, advanced autolysis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity and pregestational type 2 diabetes with poor metabolic control\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e14\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e34\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal overweight, twin pregnancy\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e15\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e30\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, acute pancreatitis that required surgical intervention\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e16\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e22.1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, advanced maternal age\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e17\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e29\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eComplete placenta previa\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, advanced maternal age, placenta previa\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e18\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e32\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eOligohydramnios, double nuchal cord\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, oligohydramnios, nuchal cord\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e19\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e29\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFrontoparietal bilateral porencephaly, intracranial hemorrhage (grade I), microcephaly, corpus callosum hypoplasia, cerebellar vermis hypoplasia, small for gestational age, hyperechogenic bowel, oligohydramnios.\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eHypertelorism, pterygium in elbows, knees, and feet\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMassive autolysis\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNo risk factor, monogenic cause suspected, probable lethal multiple pterygium syndrome\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e20\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e35.1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eBilateral pes varus\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot authorized\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, fetus with weight above 90\\u003csup\\u003eth\\u003c/sup\\u003e percentile\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 4.66%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e21\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.08%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eFemale\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 6.28%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e38\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 14.44%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 16.1%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 10.64%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 17.74%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNot authorized\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 7.84%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eNormal\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 15.2%;border-color: currentcolor currentcolor windowtext;border-style: none none solid;border-width: medium medium 1pt;border-image: none 100% / 1 / 0 stretch;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003eMaternal obesity, fetus with weight above 90\\u003csup\\u003eth\\u003c/sup\\u003e percentile\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:2.85pt;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cspan style='font-size:13px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Stillbirth, risk factor, obesity, diabetes\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-647477/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-647477/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"Purpose\\n\\nStillbirth is an important health problem in obstetrics practice. In Mexico, half of the stillbirths have an explainable cause. The aim of this study was to detect potential stillbirth risk factors and etiology by implementing a multidisciplinary workup at the Hospital Universitario “Dr. José Eleuterio González”.\\n\\nMethods\\n\\nThis is a prospective, descriptive, observational study that included stillbirths from the Obstetrics Service from October 1st, 2019 to May 25, 2020. Evaluation strategies included a complete maternal medical history, physical examination of the fetus, and a photographic medical record. A stillbirth needed to have either a prenatal ultrasound, or a postnatal x-ray, and if possible, a fetal autopsy. Multiplex Ligation Probe Amplification (MLPA) was performed with an umbilical cord sample.\\n\\nResults\\n\\nThirty-three stillbirths were reported; 21 were included in the analysis. Eleven mothers (52.3%) had known risk factors for stillbirth, mainly elevated body mass index and diabetes. On physical examination, external birth defects were found in 8 fetuses (38%). X-ray was performed in 14 cases (66%). Alterations were detected as a probable etiologic cause just in one. All cases underwent MLPA, which were reported negative. Three cases had criteria for autopsy. Findings were inconclusive to determine etiology.\\n\\nConclusion\\n\\nDiabetes and obesity were the most frequent risk factors associated with stillbirth in this Mexican population. These factors are preventable by implementing strategies that lead to better prenatal care.\",\"manuscriptTitle\":\"Obesity and Diabetes as Main Risk Factors for Stillbirth in a Population from Northeastern Mexico\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2021-07-16 18:21:16\",\"doi\":\"10.21203/rs.3.rs-647477/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"34523ee8-ea40-4ab8-be08-394061a7ce4e\",\"owner\":[],\"postedDate\":\"July 16th, 2021\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":5781357,\"name\":\"Obstetrics \\u0026 Gynecology\"}],\"tags\":[],\"updatedAt\":\"2021-07-16T18:21:16+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2021-07-16 18:21:16\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-647477\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-647477\",\"identity\":\"rs-647477\",\"version\":[\"v1\"]},\"buildId\":\"GqpaHPwrfC8PjnIFayRh5\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}