ORIGINAL ARTICLE

CHARACTERIZATION OF FETAL DEATHS AND CARE IN A HIGH-RISK MATERNITY HOSPITAL: A CROSS-SECTIONAL STUDY

Kauane Vicari1, Tatiane Herreira Trigueiro2, Larissa de Oliveira Peripolli3, Karine Amanda de Arruda4, Marcelexandra Rabelo5

1 Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR/Ebserh). Curitiba, PR, Brazil. ORCID: 0000-0001-8228-6046. Email: kauane.vicari@gmail.com.   

2 Setor de Ciências da Saúde, Departamento de Enfermagem, Universidade Federal do Paraná. Curitiba, PR, Brazil. ORCID: 0000-0003-3681-4244. Email: tatiherreira@gmail.com.  

3 Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR/Ebserh). Curitiba, PR, Brazil. ORCID: 0000-0003-0582-874X. Email: lperipolli@gmail.com.

4 Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR/Ebserh). Curitiba, PR, Brazil. ORCID: 0000-0001-5760-0988. Email: ka.aarruda@gmail.com.   

5 Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR/Ebserh). Curitiba, PR, Brazil. ORCID: 0000-0002-0291-5373. Email: marcelexandrar@gmail.com.

ABSTRACT

Objective: To describe and analyze the profile of fetal deaths and the care provided in a high-risk maternity hospital. Method: Quantitative, cross-sectional research with retrospective collection of secondary data, conducted at a high-risk maternity hospital in Curitiba, Paraná. Thirty-six stillbirth records from 35 women treated in 2022 were analyzed. Data collection occurred in 2023, featuring descriptive analysis and the application of Fisher's exact test (significance level of 7%; p=0.07). Results: Women aged between 20 and 34, classified as high-risk and multigravida, prevailed. Regarding care, 13 non-pharmacological pain relief methods were recorded, with direct involvement of nurses and physicians. Most deaths occurred in the antepartum period, with a predominance of extremely low birth weight and female fetuses. There was a statistical association between maternal risk stratification and the timing of death (p=0.06), as well as between gestational age and the total number of non-pharmacological pain relief methods applied (p=0.01). Conclusion: The study contributed to the visibility of comprehensive care in pregnancy loss, highlighting the essential role of the multidisciplinary team, the offering of care for the re-signification of grief, and the implementation of protocols for the standardization of procedures.

Descriptors: Fetal death; Pregnancy complications; Humanized childbirth.

What is already known:

• Fetal death directly impacts perinatal health indicators and the quality of obstetric care, in addition to profoundly affecting the mental health of those involved.

• Its causes are related to fetal, maternal, or placental factors, varying according to gestational age and the quality of prenatal care.

• Humanized care and bereavement support are recommended by international guidelines, although gaps still exist in clinical practice.

What this article adds:

• The relevance of understanding the specific obstetric profile of a population assisted in a high-risk maternity hospital, allowing for the detailed identification of current care practices in the context of fetal death.

• The identification of weaknesses in care, providing a foundation for actions that promote comprehensive care, such as continuous emotional support and the sensitization of the multidisciplinary team.

• The proposal for the development and implementation of humanized institutional protocols, aiming to standardize procedures and facilitate the experience and processing of grief by those involved.

INTRODUCTION

Fetal death has profound impacts on perinatal health indicators and the quality of life of those involved(1). Furthermore, the Fetal Mortality Rate (FMR) constitutes an important indicator of the quality of care provided during pregnancy and childbirth(2).

Approximately 1.9 million stillbirths were recorded globally in 2023, corresponding to an estimated rate of 14.3 fetal deaths per 1,000 total births—a value significantly lower than those observed in previous decades. This declining trend highlights advances in reproductive health standards and access to obstetric services in many countries, although disparities between high- and low-income regions remain sharp(3). In Brazil, the FMR has shown a state of relative stability in recent decades; data indicate that the index went from 8.19 per 1,000 births in 1996 to 9.5 in 2015(2).

Conceptual definitions regarding fetal death vary and require terminological clarity. According to the World Health Organization (WHO), fetal death is defined as the death of a product of conception prior to the complete expulsion or extraction from the mother, regardless of the duration of pregnancy, characterized by the absence of breathing, heartbeat, umbilical cord pulsations, or voluntary muscle contraction movements(4,5). Additionally, late fetal death (or stillbirth) refers to cases where the birth weight is 1,000 g or more, or with an estimated gestational age of 28 weeks or more(5).

In Brazil, according to the Ministry of Health, the issuance of a Death Certificate (DC) is mandatory when death occurs from the 20th gestational week onwards and/or the fetus weighs 500 g or more and/or has a height of 25 cm or more (crown-heel), integrating it into the calculation of the stillbirth coefficient. Up to the 28th week of pregnancy, stillbirth is classified as early; after this period, it is termed late. Regarding the timing of delivery, death can also be classified as antepartum or intrapartum(6).

Causes are related to fetal, maternal, or placental factors and vary according to gestational age. Infections, placental abruption, and fetal malformations predominate between the 24th and 27th gestational weeks, while from the 28th week onwards, a significant portion of deaths are of unknown origin. There are also risk factors that may lead to such an outcome, such as ethnicity (higher incidence in vulnerable populations), maternal diseases (hypertensive syndromes, diabetes, and thrombophilias), twin pregnancy, extremes of maternal age, history of stillbirth or complications in previous pregnancies, gestational age exceeding 41 weeks, and exposure to teratogens such as tobacco, alcohol, or illicit drugs(6).

In this context, assisting the delivery of a lifeless fetus constitutes a situation of extreme vulnerability for professionals, the woman, and her support network(7). Thus, it is the responsibility of the healthcare team to offer humanized and holistic care to women diagnosed with fetal death(8).

Given the above, this study is justified by the relevance of characterizing the population assisted in a reference unit under the circumstance of fetal death, aiming to identify diagnostic and care-related particularities in relation to current literature. The objective of this work is to describe and analyze the profile of fetal death cases and the care provided in a high-risk maternity hospital.

METHOD

This is a quantitative, descriptive, cross-sectional study with retrospective secondary data collection. Quantitative research utilizes ordered procedures to obtain information, while descriptive study aims to observe, describe, and document aspects of a specific situation(9). Cross-sectional designs are employed to investigate phenomena at a single point in time and frequently have a retrospective character(10).

The study was conducted in the high-risk maternity unit of a large university hospital in Curitiba, Paraná. In 2022, the unit recorded an average of 294 monthly births in the Obstetric and Gynecological Surgical Center (CCOG), a sector that includes obstetric nurses and obstetricians in the direct birth assistance team.

Data collection took place between July and December 2023, through the analysis of the birth indicators spreadsheet and the physical record book of admissions and fetal deaths at the CCOG. All antepartum and intrapartum fetal death cases whose births occurred at the institution between January and December 2022 were included. Duplicate records (n=1), cases with an Apgar score greater than or equal to 1 in the first minute (n=5), births occurring outside the maternity hospital (n=1) or home births (n=3), and gestational losses that did not fit the Ministry of Health's concept of fetal death (n=7) were excluded. Thus, the final sample consisted of 36 stillbirth records from 35 women treated.

To organize the data collection, an instrument was developed in Microsoft Excel containing variables related to: patients (age, risk stratification, parity, sector of origin, and reason for admission); care (induction methods, pharmacological and non-pharmacological pain relief methods, interventions, mode of birth, maternal birth position, presence of perineal laceration, assisting professional, postpartum care, multidisciplinary assistance, and length of stay); and newborns (timing of death, classification by weight and gestational age, sex, resuscitation maneuvers, skin-to-skin contact, time the body remained in the CCOG, and request for autopsy).

Data were subjected to descriptive analysis in Microsoft Excel 2013. To verify the association between the variables "gestational age" and "total pain relief methods," as well as between "maternal risk stratification" and "timing of fetal death," Fisher's exact test was applied with a significance level of 7% (p=0.07) and adjusted standardized residual analysis. The adopted significance level is justified by the sample size, aiming to identify substantial correlations and ensure the inclusion of variables with relevant explanatory power.

To ensure methodological rigor, the study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guidelines(11). The research complies with ethical precepts for studies involving human subjects, having been approved by the institution's Research Ethics Committee on January 18, 2022 (CAAE Opinion: 51476321.2.0000.0096), in accordance with current Brazilian resolutions.

RESULTS

Of the 35 (100%) women treated, the primary point of entry to the CCOG was the Gynecological and Obstetric Emergency Department in 31 (88.57%) cases, while four (11.43%) were referred from the Rooming-in units. Among the reasons for admission to the CCOG, labor induction due to fetal death stood out in 16 (45.71%) cases, and preterm labor in nine (25.71%). Other causes included fetal death (previous diagnosis) in three (8.57%), full-term labor in two (5.71%), and isolated cases (2.86% each) of hyperthermia, pre-eclampsia, suspected fetal death, post-term pregnancy, and premature rupture of membranes.

Regarding prenatal care, 18 (51.43%) women attended at least one consultation; in 16 (45.71%) cases, this information was not recorded, and one (2.86%) patient did not receive follow-up. Detailed maternal characteristics are provided in Table 1.

Table 1 - Maternal characteristics of patients treated at the CCOG in 2022. Curitiba, PR, Brazil, 2023

Source: prepared by the authors, 2025.

Regarding labor induction methods, vaginal misoprostol was used in 14 (40.00%) cases, intracervical Foley catheter in 12 (34.29%), and intravenous synthetic oxytocin in 10 (28.57%). Of the 21 (100%) patients who underwent induction, nine (42.86%) used only one method, while in nine (42.86%) there was an association of two methods, and in three (14.29%), all three methods were used in combination. It is noteworthy that 12 (34.29%) women did not undergo induction, and for two (5.71%), there was no record.

Regarding assistance during labor and birth (Table 2), 33 (94.28%) patients used at least one non-pharmacological pain relief method. In the pharmacological field, analgesia (spinal or epidural) was performed in only three (8.57%) cases and was not used in 19 (54.29%); however, there was a high absence of records regarding this intervention, corresponding to 13 (37.14%) patients. 

Table 2 - Characteristics of labor and birth care for patients treated at the CCOG in 2022. Curitiba, PR, Brazil, 2023

Source: prepared by the authors, 2025.

Regarding interventions, 22 (62.86%) records indicated that the Kristeller maneuver was not performed; however, in 13 (37.14%) cases, this data is unknown due to incomplete information. Furthermore, 14 (40.00%) women did not receive any of the interventions described in Table 2, seven (20.00%) underwent at least one of them, two (5.71%) underwent two, and in 12 (34.29%) medical records, this information was not registered. Additionally, 12 (34.29%) patients underwent curettage during the postpartum period.

Regarding postpartum care, pharmacological inhibition of lactation was administered to 32 (91.43%) women. After discharge, 12 (34.29%) were referred for psychological follow-up in Primary Health Care. Multiprofessional care during hospitalization was characterized by medical assistance to all 35 (100%) women, nursing care to 34 (97.14%), social services to 30 (85.71%), and psychology to 21 (60.00%); occupational therapy, physiotherapy, dentistry, and nutrition provided care to one (2.86%) patient each. The average length of hospital stay was over 46 hours, with an interval ranging between 7 and 218 hours.

Fetal characteristics are detailed in Table 3. The presence of a pediatrician was observed in 17 (47.22%) births and their absence in one (2.78%); in 18 (50.00%) cases, there was no record of this assistance.

Table 3 - Characteristics of stillborn infants treated at the CCOG in 2022. Curitiba, PR, Brazil, 2023

Source: prepared by the authors, 2025.

There was also a statistically significant association between the total number of non-pharmacological pain relief methods used by the women and the classification of the newborns (NB) according to gestational age (p=0.01). The adjusted standardized residual analysis showed a positive association when the NB is classified as very preterm and there is a record of only one pain relief method applied, as well as in cases of full-term NB with the application of eight and nine methods. Conversely, a lower frequency of cases was observed when the NB is late preterm and only one method was performed. These data are detailed in Table 4.

Table 4 - Analysis of adjusted standardized residuals between newborn classification by gestational age and the quantity of non-pharmacological pain relief methods performed in 2022. Curitiba, PR, Brazil, 2023

Source: prepared by the authors, 2025.

Additionally, Fisher's exact test demonstrated a statistical association between the variables "maternal risk stratification" and "timing of fetal death" (p=0.06). The analysis of adjusted standardized residuals between these variables is detailed in Table 5.

Table 5 - Analysis of adjusted standardized residuals between the timing of fetal death and maternal risk stratification in 2022. Curitiba, PR, Brazil, 2023.

Source: prepared by the authors, 2025.

DISCUSSION

Regarding the obstetric profile, the predominant age group (25 to 29 years) accounted for 40% of fetal death cases, with a significant density in the 20 to 34-year range. These data corroborate the 2021 national scenario, in which this age group was prevalent in almost all regions of the country, except for the North region(12). In the South region specifically, it is observed that women between 25 and 29 years old present fetal death rates higher than those between 20 and 24 years old(12).

In relation to the type of pregnancy, for the same year, the number of fetal deaths in single pregnancies in Brazil was higher than in multiple pregnancies, corresponding to 91.91%(12). Considering the above, the results of this research align with the national reality. Regarding prenatal care, although 51.43% of the women attended at least one consultation, the high rate of incomplete records compromises a reliable analysis of this factor. It is worth noting that the Ministry of Health recommends a minimum of six consultations, with early initiation in the first trimester and increasing frequency as gestational age advances, alternating care between physicians and nurses in low-risk prenatal care(13).

In the scope of childbirth care, the presence of a companion stands out in 88.57% of cases as a non-pharmacological method of pain relief. This is a right guaranteed by law since 2005 and reinforced in 2023, ensuring the presence of a person of the woman’s choice in public and private units throughout the entire period of care(14,15). Literature demonstrates that emotional support from a companion strengthens family bonds and humanizes professional conduct, assisting in patient safety and the physiological evolution of the process, as well as in pain alleviation(16).

The research evidenced that the lower the gestational age at the time of death, the lower the number of pain relief methods used. It is imperative that holistic and humanized care be guaranteed regardless of fetal viability. A study conducted in a public maternity hospital in Southern Brazil pointed out that, in a situation of gestational loss, labor assistance is perceived as difficult to monitor by professionals; the fragmentation of care and the limited offering of guidance on pain relief methods result in the restriction of women's choice regarding the mode of birth(17).

Regarding the multidisciplinary team, its importance is based on both prevention and the outcome of fetal death care. Quality prenatal monitoring and comprehensive health care are fundamental to preventing unfavorable outcomes, as well as for providing support in facing grief. The need for research investigating high-risk pregnancy monitoring—the group that represented the largest number of antepartum deaths in this study—is emphasized to identify weaknesses in the care network and improve assistance.

Comparative studies between Brazil and Canada highlight differences in care, mainly regarding support for preventing complicated grief. Physical contact with the baby, interaction, and the act of keeping mementos (objects, photos, or videos), in addition to professional support after the loss, are means that assist the family in processing grief(18). Other studies address the team's responsibility in encouraging the creation of memories: seeing, touching, bathing, changing, and naming the baby are fundamental care rituals(19). The need to respect each family's culture and their possible refusal of contact is emphasized, leaving it to the team, with an emphasis on the nurse, to offer such care sensitively.

Although the institution does not have formal records of these rituals, the data show that the baby's body remains in the sector between 1 and 6 hours in 47.22% of cases—a viable interval for the team to offer support. Furthermore, indicators demonstrated that skin-to-skin contact occurred in 36.11% of cases; this care could be further encouraged so that more families benefit. It is noteworthy that assisting the birth of a lifeless fetus represents a delicate experience for professionals, whose discomfort may reflect on the quality of care, especially due to the lack of institutional support to deal with such situations(7,20). Protocols such as SPIKES and the Royal College of Obstetricians & Gynaecologists guideline can guide the team in this process(21,22).

In this study, it was observed that 91.43% of the women underwent pharmacological inhibition of lactation, 60.00% received institutional psychological care, and 34.29% were referred to primary care. The lack of a specific institutional protocol results in psychological care coverage that may reflect structural limitations or the number of professionals available to meet the demand.

Regarding fetal characteristics, 63.89% of deaths occurred in the antepartum period, which corroborates 2021 IBGE data (89.84%)(12). However, there was a divergence regarding sex: in this research, female prevailed (58.33%), while in the national scenario, male prevails(12). Regarding weight and gestational age, this study pointed to a predominance of extreme preterm and extremely low birth weight infants, opposing the national trend of moderate preterm and low birth weight(12).

Among the study's limitations, the difficulty in data collection due to the segmentation of records and the absence of an institutional protocol stand out, which hinders the compilation of information. The incompleteness of data demonstrates weakness in the recording process by professionals and the inefficiency of the current method of capturing information in cases of fetal death.

CONCLUSION

It is emphasized that humanized care must begin with the reception provided by the nurse at the service's entry point, permeating pre-birth, birth, and the postpartum period. It is essential that these patients have access to holistic care, regardless of fetal viability.

This study contributes to giving visibility to bereavement care, highlighting as essential the multidisciplinary monitoring, the offering of care rituals for the re-signification of the process, and the implementation of protocols that standardize procedures in gestational loss.

Finally, it is inferred that the proposed objective was achieved, suggesting a reorganization of care and the recording of losses. Such a measure aims to provide greater visibility to these cases, considering the close relationship between the fetal mortality rate and the quality of care provided in the health network.

CONFLICT OF INTERESTS

The authors declare that there is no conflict of interest.

REFERENCES

1. Brasil. Secretaria de Saúde do Estado do Ceará. Linha de cuidado à saúde da mulher na perda perinatal [Internet]. Fortaleza: Secretaria da Saúde do Estado do Ceará; 2025 [cited 2025 Dec 01]. Available from: https://www.saude.ce.gov.br/wp-content/uploads/sites/9/2025/01/RESOLUCAO-525-ANEXO-Linha-de-Cuidado-a-Saude-da-Mulher-na-Perda-Perinatal.pdf

2. Rocha JBF, Bezerra IMP, Oliveira EK da S, Sena ABE, Leitão FNC, Abreu LC. Space-time trends in fetal mortality in Brazil, 1996-2021. Rev Saude Publica. 2025;59:e2. https://doi.org/10.11606/s1518-8787.2025059006194 PMID: 40172471

3. United Nations Children’s Fund, World Health Organization, World Bank Group, United Nations Department of Economic and Social Affairs, United Nations Economic Commission for Latin America and the Caribbean, Standing up for stillbirth: current estimates and key interventions. Report of the United Nations Inter-agency Group for Child Mortality Estimation, 2024 [Internet]. New York: UNICEF; 2024 [cited 2025 Dec 2]. Available from: https://data.unicef.org/wp-content/uploads/2025/04/UNIGME-Stillbirth-Report-2024.pdf

4. Brasil. Ministério da Saúde. Síntese de evidências para políticas de saúde: reduzindo a mortalidade perinatal [Internet]. 3. ed. Brasília: Ministério da Saúde; 2016 [cited 2025 Jul 12]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/sintese_evidencias_politicas_mortalidade_perinatal_3ed.pdf

5. World Health Organization. International classification of diseases for mortality and morbidity statistics (ICD-11) [Internet]. Geneva: WHO; 2023 [cited 2025 Jun 10]. Available from: https://icd.who.int/browse11

6. Brasil. Ministério da Saúde. Manual de gestação de alto risco [Internet]. Brasília: Ministério da Saúde; 2022 [cited 2025 Jun 11]. Available from: https://aps.saude.gov.br/biblioteca/visualizar/MjA4Ng%E2%87%92

7. Ssegujja E, Ddumba I, Andipatin M. An exploration of health workers' experiences in providing bereavement care to mothers following a stillbirth: results from a subnational level health system in Uganda. BMC Pregnancy Childbirth. 2023;23(1):588. https://doi.org/10.1186/s12884-023-05913-x PMID: 37592205

8. O'Connor E, Leitao S, Fogarty AP, Greene R, O'Donoghue K. A systematic review of standardised tools used in perinatal death review programmes. Women Birth. 2024;37(1):88-97. https://doi.org/10.1016/j.wombi.2023.09.006 PMID: 37793961

9. Kosie J, Lew-Williams C. Open Science Considerations for Descriptive Research in Developmental Science. Infant Child Dev. 2024;33(1):e2377. https://doi.org/10.1002/icd.2377 PMID: 38389731

10. Pérez-Guerrero EE, Guillén-Medina MR, Márquez-Sandoval F, Vera-Cruz JM, Gallegos-Arreola MP, Rico-Méndez MA et al. Methodological and Statistical Considerations for Cross-Sectional, Case-Control, and Cohort Studies. J Clin Med. 2024;13(14):4005. https://doi.org/10.3390/jcm13144005 PMID: 39064045

11. Dewidar O, Shamseer L, Melendez-Torres GJ, Akl EA, Ramke J, Wang X, et al. Improving the Reporting on Health Equity in Observational Research (STROBE-Equity): Extension Checklist and Elaboration. JAMA Netw Open. 2025;8(9):e2532512. https://doi.org/10.1001/jamanetworkopen.2025.32512 PMID: 40899932.

12. Brasil. Ministério da Saúde. Departamento de Informática do Sistema Único de Saúde (DATASUS) [Internet]. Brasília: Ministério da Saúde; 2021 [cited 2025 Oct 20]. Available from: http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sim/cnv/fet10uf.def

13. Brasil. Ministério da Saúde. Atenção ao pré-natal de baixo risco [Internet]. Brasília: Editora do Ministério da Saúde; 2013 [cited 2025 May 10]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/cadernos_atencao_basica_32_prenatal.pdf

14. Brasil. Lei nº 11.108, de 7 de abril de 2005. Altera a Lei nº 8.080, de 19 de setembro de 1990, para garantir às parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do Sistema Único de Saúde - SUS. Diário Oficial da União [Internet]. 7 abr 2005 [cited 2025 May 20]. Available from: https://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm

15. Brasil. Lei nº 14.737, de 27 de novembro de 2023. Altera a Lei nº 8.080, de 19 de setembro de 1990 (Lei Orgânica da Saúde), para ampliar o direito da mulher de ter acompanhante nos atendimentos realizados em serviços de saúde públicos e privados. Diário Oficial da União [Internet]. 27 nov 2023 [cited 2025 May 20]. Available from: https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2023/lei/l14737.htm

16. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766. https://doi.org/10.1002/14651858.cd003766.pub6 PMID: 28681500

17. Rocha L, Costa R, Gomes Í EM, Alves IFB de O, Rosa R, Lima MM. Dificuldades enfrentadas pela enfermagem no cuidado à mulher com óbito fetal. Saberes Plurais Educ. Saude. 2023;7(1):e128168. https://doi.org/10.54909/sp.v7i 1.128168

18. Paris GF, Montigny F, Pelloso SM. Professional practice in caring for maternal grief in the face of stillbirth in two countries. Rev Bras Enferm. 2021;74(3):e20200253. https://doi.org/10.1590/0034-7167-2020-0253 PMID: 34133679

19. Peberdy L, Young J, Massey D, Kearney L. Integrated review of the knowledge, attitudes, and practices of maternity health care professionals concerning umbilical cord clamping. Birth. 2022;49(4):595-615. https://doi.org/10.1111/birt.12647 PMID: 35582849

20. Serafim TC, Camilo BHN, Carizani MR, Gervasio M de G, Carlos DM, Salim NR. Attention to women in situation of intrauterine fetal death: experiences of health professionals. Rev Gaucha Enferm. 2021;42:e20200249. https://doi.org/10.1590/1983-1447.2021.20200249 PMID: 34037113

21. Martins NQB, Thomazini MG, Rodrigues MT, Matos MS, Souto RR. Comunicação de más notícias através do protocolo SPIKES: uma revisão bibliográfica. Rev. Master. 2023;8(15). https://doi.org/10.47224/revistamaster.v8i15.414

22. Royal College of Obstetricians & Gynaecologists. Care of parents following stillbirth and neonatal death [Internet]. London: RCOG; 2022 [cited 2025 Nov 14]. Available from: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/care-of-parents-following-stillbirth-and-neonatal-death-green-top-guideline-no-55/

Submission: 19-Dec-2025

Approved: 20-Feb-2026

Editors:

Rosimere Ferreira Santana (ORCID: 0000-0002-4593-3715)

Geilsa Soraia Cavalcanti Valente (ORCID: 0000-0003-4488-4912)

Carla Oliveira Shubert (ORCID: 0000-0002-3406-3160)

Corresponding author: Kauane Vicari (kauane.vicari@gmail.com)

Publisher:

Escola de Enfermagem Aurora de Afonso Costa – UFF

Rua Dr. Celestino, 74 – Centro, CEP: 24020-091 – Niterói, RJ, Brazil

Journal email: objn.cme@id.uff.br