Maternal and fetal factors associated with stillbirth in singleton pregnancies in 13 hospitals across six states in India: A prospective cohort study
Maternal and fetal factors associated with stillbirth in singleton pregnancies in 13 hospitals across six states in India: A prospective cohort study
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DOI：
10.1002/ijgo.15367
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发表时间：
2024-01-17
影响因子：
3.8
通讯作者：
Nair，Manisha
中科院分区：
文献类型：
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作者：
Boo，Yebeen Ysabelle;Bora，Amrit K.;Nair，Manisha
本研究旨在调查印度人口死产的发病率和危险因素。方法我们对来自印度孕产妇和围产期健康研究合作组织（MaatHRI）的医院队列进行了二次数据分析，包括2018年10月至2023年9月期间分娩的孕妇。从印度6个邦的13家医院招募的9823例单胎妊娠的数据包括在内。进行单变量和多变量Poisson回归分析以检查死产与潜在危险因素之间的关系。模型预测进行了评估，使用受试者工作特征（AUROC）curve.ResultsThere下的面积216死产（48产前和168产时）在研究人群中，总死产率为22.0每1000总出生（95%置信区间[CI]：19.2-25.1）。死产的可调整风险因素是：接受少于四次产前检查（调整后的相对风险[aRR]：1.75，95% CI：1.25-2.47），妊娠期间未服用任何铁和叶酸补充剂（aRR：7.23，95% CI：2.12-45.33）和妊娠晚期重度贫血（aRR：3.37，95% CI：1.97-6.11）。有妊娠/胎儿并发症，如妊娠高血压疾病（aRR：1.59，95% CI：1.03-2.36），早产（aRR：4.41，95% CI：3.21-6.08）和出生体重低于胎龄第10百分位数（aRR：1.35，95% CI：1.02-1.79）也与死产风险增加相关。确定的危险因素解释78.2%（95%CI：75.0%-81.4%）的风险死产的population.ConclusionAddressing潜在的可修改的产前因素，可以减少死产的风险在印度。
ObjectiveThis study aimed to investigate the incidence of and risk factors for stillbirth in an Indian population.MethodsWe conducted a secondary data analysis of a hospital‐based cohort from the Maternal and Perinatal Health Research collaboration, India (MaatHRI), including pregnant women who gave birth between October 2018–September 2023. Data from 9823 singleton pregnancies recruited from 13 hospitals across six Indian states were included. Univariable and multivariable Poisson regression analysis were performed to examine the relationship between stillbirth and potential risk factors. Model prediction was assessed using the area under the receiver‐operating characteristic (AUROC) curve.ResultsThere were 216 stillbirths (48 antepartum and 168 intrapartum) in the study population, representing an overall stillbirth rate of 22.0 per 1000 total births (95% confidence interval [CI]: 19.2–25.1). Modifiable risk factors for stillbirth were: receiving less than four antenatal check‐ups (adjusted relative risk [aRR]: 1.75, 95% CI: 1.25–2.47), not taking any iron and folic acid supplementation during pregnancy (aRR: 7.23, 95% CI: 2.12–45.33) and having severe anemia in the third trimester (aRR: 3.37, 95% CI: 1.97–6.11). Having pregnancy/fetal complications such as hypertensive disorders of pregnancy (aRR: 1.59, 95% CI: 1.03–2.36), preterm birth (aRR: 4.41, 95% CI: 3.21–6.08) and birth weight below the 10th percentile for gestational age (aRR: 1.35, 95% CI: 1.02–1.79) were also associated with an increased risk of stillbirth. Identified risk factors explained 78.2% (95% CI: 75.0%–81.4%) of the risk of stillbirth in the population.ConclusionAddressing potentially modifiable antenatal factors could reduce the risk of stillbirths in India.