Stillbirth and neonatal mortality in pregnancies complicated by major congenital anomalies: Findings from a large European cohort
Stillbirth and neonatal mortality in pregnancies complicated by major congenital anomalies: Findings from a large European cohort
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DOI：
10.1002/pd.5148
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发表时间：
2017-11-01
影响因子：
3
通讯作者：
de Walle, Hermien E. K.
中科院分区：
文献类型：
--
作者：
Groen, Henk;Bouman, Katelijne;de Walle, Hermien E. K.
目的提供预后信息，帮助父母就终止或继续妊娠做出明智的决定，并根据大型欧洲队列制定围产期政策。方法来自欧洲先天性异常监测（EUROCAT）网络的 13 个登记处提供了 1998 年 1 月 1 日至 2011 年 12 月 31 日的数据。排除了胎儿异常终止妊娠。根据 EUROCAT 指南区分染色体异常、综合征和孤立异常组。按异常组和胎龄对围产期死亡率、死产以及早期和晚期新生儿死亡率 (NMR) 进行分析。结果在 73337 例病例中，先天性异常相关的围产期死亡率为每 1000 名新生儿 1.27 例（95% 置信区间为 1.23-1.31）。平均死产率为 2.68%（范围 0%-51.2%）。早期和晚期 NMR 分别为 2.75%（范围 0%-46.7%）和 0.97%（范围 0%-17.9%）。与一般人群相比，染色体异常和综合征以及大多数孤立的异常在胎儿死亡时间方面存在显着差异。染色体和中枢神经系统异常的足月死产率较高。结论我们发现异常之间在死产率、核磁共振和按胎龄计时方面存在相关差异。我们的数据可以帮助父母决定他们未出生的孩子是否患有先天性异常，并帮助母婴医学专家了解围产期管理。
ObjectiveTo provide prognostic information to help parents to reach an informed decision about termination or continuation of the pregnancy and to shape peripartum policy based on a large European cohort.MethodThirteen registries from the European Surveillance of Congenital Anomalies (EUROCAT) network contributed data from January 1, 1998, to December 31, 2011. Terminations for fetal anomalies were excluded. Chromosomal anomalies, syndromes and isolated anomaly groups were distinguished according to EUROCAT guidelines. Perinatal mortality, stillbirths, and early and late neonatal mortality rates (NMRs) were analyzed by anomaly group and gestational age.ResultsAmong 73337 cases, perinatal mortality associated with congenital anomaly was 1.27 per 1000 births (95% confidence interval, 1.23-1.31). Average stillbirth rate was 2.68% (range 0%-51.2%). Early and late NMR were 2.75% (range 0%-46.7%) and 0.97% (range 0%-17.9%), respectively. Chromosomal anomalies and syndromes, and most isolated anomalies, had significant differences regarding timing of fetal demise compared to the general population. Chromosomal and central nervous system anomalies had higher term stillbirth rates.ConclusionsWe found relevant differences between anomalies regarding rates of stillbirth, NMR, and timing by gestational age. Our data can help parents to decide about their unborn child with a congenital anomaly and help inform maternal-fetal medicine specialists regarding peripartum management.