RESEARCH ON SCOPE & CAUSES OF STILLBIRTH IN THE US

范围研究

• 批准号: 7789209
• 负责人: DONALD R COUSTAN
• 金额: $ 14.73万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-26 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7789209
• 关键词: Abruptio Placentae; Activities of Daily Living; Age; Anti-Inflammatory Agents; Anti-inflammatory; Apoptosis; Apoptotic; Area; Autopsy; Biological Assay; Birth; CD8-Positive T-Lymphocytes; Caring; Cell Death; Cells; Chromosome abnormality; Clinical; Collaborations; Communities; Complement; Control Groups; County; Coupled; Databases; Dimensions; Discipline of obstetrics; Environment; Fetal Growth Retardation; Fetal Weight; Fetus; Gestational Age; Goals; Growth; Health; Health Personnel; Histologic; Hospitals; Immune; Immunohistochemistry; In Vitro; Infant; Inflammatory; Interferon Type II; Interleukin-10; Ischemia; Leadership; Measures; Modeling; Mothers; Natural Killer Cells; Neonatal; Neonatology; Neurokinin B; Nurses; Paraffin; Pathology; Patients; Phenotype; Physicians; Placenta; Population; Population Heterogeneity; Pre-Eclampsia; Premature Labor; Process; Production; Renin; Reproductive Health; Research; Resources; Rhode Island; Sampling; Serum; Services; Spontaneous abortion; Stable Populations; TdT-Mediated dUTP Nick End Labeling Assay; Testing; Time; Tissues; Tumor Necrosis Factor-alpha; Unexplained stillbirth; Woman; Women' s Role; base; case control; cytokine; cytotoxic; cytotoxicity; fetal; human TNF protein; macrophage; maternal serum; maternal serum markers; medical specialties; neutrophil; outreach program; peripheral blood; population based; stillbirth; trend; trophoblast

DESCRIPTION (provided by applicant): Women and Infants Hospital (WIH) has served as the regional resource for tertiary obstetrical and neonatal care for decades for all the communities in Rhode Island and those of Bristol County, MA. This compact, contiguous area, well defined by state and county boundaries, contains a stable, but racially and ethnically heterogeneous population, producing 20,000 total births and more than 100 stillbirths, annually. Births at WlH represent over 70% of those that occur state-wide and nearly half of those in the region, and are highly representative of those from the region's population. As a specialty hospital, WIH has maintained an active outreach program to the region's nurses, physicians and hospitals for the past 26 years. This active engagement has included educational support in the areas of neonatology, obstetrics and pathology. WlH has also maintained an active collaboration with the Rhode Island Department of Health (DOH) in many initiatives regarding reproductive health. This proposal is made with the enthusiastic support of the Departments of Health of both states and the chiefs of obstetrics and pathology and administration of all the region's 14 hospitals with obstetrical services. The Department of Pathology at WIH has maintained an extensive relational database of its autopsy and placental examinations and relevant clinical information since 1975. Paraffin-imbedded standard tissues sections from these examinations also provide for examination of time-trends of stillbirths occurring in a stable population over the past two decades. The Department has sustained an 80% autopsy rate at WIH and stimulated the rising rate among the other region's hospitals, now at 30%. A rising proportion of the stillbirths occurring at other hospitals are being referred to WlH for autopsy and placental examination. Consequently, because of the leadership role of WIH in RI and Bristol County, MA, the close proximity of the 14 hospitals serving its population, and the collegial relations among health care providers, this region is well adapted to provide the resources for a population-based study of the causes of stillbirth in a stable, diverse population-based sample of 20,000 annual births.

描述(由申请人提供)：几十年来，妇女和婴儿医院(WIH)一直是罗德岛和马萨诸塞州布里斯托尔县所有社区的三级产科和新生儿护理的区域资源。这个紧凑、毗连的地区由州和县的边界很好地界定，包含了稳定的、但种族和民族混杂的人口，每年产生20,000名新生儿和100多名死胎。华盛顿州的出生率占全州出生率的70%以上，占该地区出生率的近一半，并且高度代表该地区人口的出生率。 作为一家专科医院，WIH在过去26年里一直积极向该地区的护士、医生和医院开展外展计划。这一积极参与包括在新生儿学、产科和病理学领域的教育支持。世界卫生组织还在许多有关生殖健康的倡议中与罗德岛卫生部保持积极合作。这项建议得到了两个州的卫生部以及该地区所有14家提供产科服务的医院的产科、病理学和行政主管的热情支持。 WIH病理学系自1975年以来一直维护其尸检和胎盘检查以及相关临床信息的广泛关系数据库。这些检查的石蜡包埋标准组织切片还提供了过去20年来在稳定人口中发生的死产的时间趋势的检查。该部门在世界卫生组织保持了80%的尸检率，并刺激了其他地区医院的尸检率上升，目前为30%。在其他医院发生的死产中，越来越多的死产被转到世界卫生组织进行尸检和胎盘检查。因此，由于世界卫生组织在国际扶轮和马萨诸塞州布里斯托尔县的领导作用、为其人口服务的14家医院的临近以及卫生保健提供者之间的合作关系，该地区非常适合在每年20,000名新生儿的稳定、多样化的人口样本中为死产原因的基于人口的研究提供资源。