Unexplained antepartum fetal deaths: what are the determinants?
Unexplained antepartum fetal deaths: what are the determinants?
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DOI：
10.1007/s00404-004-0606-1
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发表时间：
2005-04-05
影响因子：
2.6
通讯作者：
Chibber, Rachana
中科院分区：
文献类型：
--
作者：
Chibber, Rachana
目的：目的是评估胎儿，产前和妊娠原因不明的产前胎儿死亡的决定因素。方法：这是一项以医院为基础的队列研究，从1995年1月至2002年12月，对34,394名体重500 g或以上的新生儿进行了研究。不明原因的胎儿死亡定义为分娩前发生的胎儿死亡，没有明显的胎儿、母体或胎盘病理学证据。结果：不明原因的产前死胎98例，占360例死胎的27.2%。这些死亡中有三分之二发生在妊娠36周之后。以下因素与不明原因的胎儿死亡独立相关：（OR 1.74; 95% CI 1.21，2.86）;产次≥ 5次（OR 1.19; 95% CI 1.26，3.26）;社会经济地位低（OR 1.22; 95% CI 1.14，2.86）;母亲年龄≥ 40岁（OR 3.62; 95% CI 1.22，4.52）;母亲年龄≤ 18岁（OR 1.79; 95% CI 0.82，2.89）;母体孕前体重大于70 kg（OR 2.20; 95% CI 1.85，3.68）;胎儿在31周或更长时间死亡的女性产前访视少于3次（OR 1.11; 95% CI 1.08，2.48）;出生体重比（定义为出生体重与胎龄平均出生体重的比值）在0.85至0.94之间（OR 1.77; 95% CI 1.28，4.18）或大于1.45（OR 2.92; 95% CI 1.75，3.21）;首次产前访视的三个月。胎儿死亡史、流产史、吸烟史、胎儿性别、低母体体重、胎儿-胎盘重量、过期妊娠与不明原因的胎儿死亡无显著相关性。结论：确定了几个与不明原因胎儿死亡风险增加相关的因素。
Objective: The objective was to assess fetal, antenatal, and pregnancy determinants of unexplained antepartum fetal death. Methods: This is a hospital-based cohort study of 34,394 births weighing 500 g or more from January 1995 to December 2002. Unexplained fetal deaths were defined as fetal deaths occurring before labor, without evidence of significant fetal, maternal or placental pathology. Results: Ninety-eight unexplained antepartum fetal deaths accounted for 27.2% of 360 total fetal deaths. Two-thirds of these deaths occurred after 36 weeks' gestation. The following factors are independently associated with unexplained fetal deaths: primiparity (OR 1.74; 95% CI 1.21, 2.86); parity of five or more (OR 1.19; 95% CI 1.26, 3.26); low socioeconomic status (OR 1.22; 95% CI 1.14, 2.86); maternal age 40 years or more (OR 3.62; 95% Cl 1.22, 4.52); maternal age of 18 years or less (OR 1.79; 95% CI 0.82, 2.89); maternal prepregnancy weight greater than 70 kg (OR 2.20; 95% CI 1.85, 3.68); fewer than three antenatal visits in women whose fetuses died at 31 weeks or more (OR 1.11; 95 % CI 1.08, 2.48); birth weight ratio (defined as ratio of birth weight to mean birth weight for gestational age) between 0.85 and 0.94 (OR 1.77; 95% Cl 1.28, 4.18) or over 1.45 (OR 2.92; 95% CI 1.75, 3.21); trimester of first antenatal visit. Previous fetal death, previous abortion, cigarette smoking, fetal sex, low maternal weight, fetal-to-placenta weight, and post date pregnancy were not significantly associated with unexplained fetal deaths. Conclusion: Several factors were identified that are associated with an increased risk of unexplained fetal deaths.