Lack of prenatal care: an independent risk factor for perinatal mortality among macrosomic newborns
Lack of prenatal care: an independent risk factor for perinatal mortality among macrosomic newborns
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DOI：
10.1007/s00404-007-0510-6
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发表时间：
2008-06-01
影响因子：
2.6
通讯作者：
Sheiner, Eyal
中科院分区：
文献类型：
--
作者：
Dickstein, Yaakov;Ohel, Iris;Sheiner, Eyal
目的探讨巨胎儿产妇产前护理不足与围产期并发症的关系。研究人群包括1988年至2003年间连续分娩的单胎胎儿，体重为4公斤及以上。在缺乏产前护理（在任何产前护理机构就诊少于三次）和有三次及以上产前护理就诊的孕妇之间进行了比较。为了探讨LOPC与围产期死亡率之间的关系，我们构建了多元logistic回归模型。结果研究期间，7332例产妇在我院分娩了巨大新生儿。其中，8.0% （n = 590）缺乏产前护理。缺乏产前护理的患者更有可能是贝都因人，胎次更高，年龄比对照组大。缺乏产前护理的患者围产期死亡率较高（OR = 5.4, 95%CI 2.8-10.5; P < 0.001）。通过多变量分析并控制巨大儿相关并发症，发现LOPC与围产期死亡率之间的相关性持续存在（OR = 4.1, 95% CI 2.1-8.1; P < 0.001）。结论缺乏产前护理是巨大新生儿围产期死亡的独立危险因素。
Objective To examine the association between lack of prenatal care (LOPC) and perinatal complications among parturients carrying macrosomic fetuses.Study design The study population consisted of consecutive women with singleton fetuses weighing 4 kg and above, delivered between the years 1988 and 2003. A comparison was performed between parturients lacking prenatal care (fewer than three visits at any prenatal care facility) and those with three and more prenatal care visits. A multiple logistic regression model was constructed in order to investigate the association between LOPC and perinatal mortality.Results During the study period, 7,332 women delivered macrosomic newborns in our institute. Of those, 8.0% (n = 590) lacked prenatal care. Patients lacking prenatal care were more likely to be Bedouins, of higher parity and older than the comparison group. Higher rates of perinatal mortality were noted among patients lacking prenatal care (OR = 5.4, 95%CI 2.8-10.5; P < 0.001). Using a multivariable analysis and controlling for macrosomia-related complications, it was found that the association between LOPC and perinatal mortality persisted (OR = 4.1, 95% CI 2.1-8.1; P < 0.001).Conclusion Lack of prenatal care is an independent risk factor for perinatal mortality among macrosomic newborns.