OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.
OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.
Authors: Gizelton Pereira Alencar; Zilda Pereira da Silva; Patrícia Carla Santos; Priscila Ribeiro Raspantini; Barbara Laisa Alves Moura; Marcia Furquim de Almeida; Felipe Parra do Nascimento; Laura C Rodrigues Journal: BMC Pregnancy Childbirth Date: 2015-07-23 Impact factor: 3.007
Authors: Yenny Djuardi; Heri Wibowo; Taniawati Supali; Iwan Ariawan; Robbert G M Bredius; Maria Yazdanbakhsh; Laura C Rodrigues; Erliyani Sartono Journal: PLoS One Date: 2009-11-09 Impact factor: 3.240
Authors: Andréa Paula Peneluppi de Medeiros; Nelson Gouveia; Reinaldo Paul Pérez Machado; Miriam Regina de Souza; Gizelton Pereira Alencar; Hillegonda Maria Dutilh Novaes; Márcia Furquim de Almeida Journal: Environ Health Perspect Date: 2008-09-22 Impact factor: 9.031