medigraphic.com
SPANISH

Revista de Investigación Clínica

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2012, Number 4

<< Back Next >>

Rev Invest Clin 2012; 64 (4)

Maternal risk factors associated to stillbirth in a public hospital at West of Mexico

Pérez-Molina J, Quezada-López C, Panduro-Barón G, Castro-Hernández JF
Full text How to cite this article

Language: Spanish
References: 17
Page: 330-335
PDF size: 154.29 Kb.


Key words:

Stillbirth, Prenatal care, Risk factors, Preterm birth.

ABSTRACT

Introduction. Mortality rates in preterm births and stillbirth are high. Objective. To identify maternal risk factors relating to stillbirth in preterm infants. Material and methods. We conducted a cross-sectional, analytic study of 1,022 newborns between 20 and 36 weeks of gestation, from September 2004 to August 2005. Stillbirth was defined as fetal death prior to expulsion or extraction from the mother. Data was collected prospectively by directly interviewing the pregnant women and from the medical chart. The dependent variable was stillbirth and the independent ones were the maternal risk factors. Associations were evaluated by logistic regression. Results. One thousand and twenty-four (1,024) preterm births were detected in a total of 14,882 births (6.9%/year). One hundred and fifty-two (152) were stillborn and 870 were live births. The fetal mortality rate was 10.3 per 1,000 live births. The least common maternal factors associated to stillbirth included: urinary tract infection (22/152, 14% vs. 224/869, 26%, p = 0.020), PMR › 24 h (18/152, 12% vs. 172/869, 20%, p = 0.020) and cesarean delivery (24/138, 17% vs. 344/719, 48%, p ‹ 0.001). The crude odd risk ratios for stillbirth included spontaneous preterm delivery (OR 4.38, CI95% 2.70-7.17) and deficient prenatal care (OR 2.64, CI95% 1.83-3.82). By multivariate analysis, stillbirth predictors included: spontaneous preterm delivery (OR 4.00, CI95% 2.61-6.61) and deficient prenatal care (OR 2.54, CI95% 1.78-3.62). Conclusion. Deficient prenatal care was the only statistically significant and clinically coherent variable predicting stillbirth.


REFERENCES

  1. Ananth CV, Vintzileos AM. Epidemiology of preterm birth and its clinical subtypes. J Matern Fetal Neonatal Med 2006; 19: 773-82.

  2. Villanueva-Egan LA, Contreras-Gutiérrez AK, Pichardo-Cuevas M, Rosales-Lucio K. Perfil epidemiológico del parto prematuro. Ginecol Obstet Mex 2008; 76: 542-8.

  3. WHO. International Classification of Diseases and Related Health Problems. 10th Revision. Vol. 2. Geneva; 1993.

  4. Estadísticas de mortalidad relacionada con la salud reproductiva. México, 2002. Sal Pub Mex 2004; 46: 75-88.

  5. Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C; GAPPS Review Group. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth 2010, 10(Suppl. 1): S1.

  6. Cnattingius S, Stphansson O. The epidemiology of stillbirth. Semin Perinatol 2002; 26: 25-30.

  7. Hernández B, Velasco-Mondragón HE. Encuestas transversales. Sal Pub Mex 2000; 42: 474-55.

  8. Capurro H, Konichezky S, Fonseca D, Caldeiro Barcia R. A simplified method for diagnosis of gestational age in the newborn infant. J Pediatr 1978; 93: 120-2.

  9. Ballard JL, Khoury JC, Wedif K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard score, expanded to include extremely premature infants. J Pediatr 1991; 119: 417-23.

  10. Norma Oficial Mexicana NOM-007-SSA2-1993. Atención de la Mujer durante el embarazo, parto y puerperio y del recién nacido. Criterios y procedimientos para la prestación del servicio.

  11. Álvarez M, Muzzo S, Ivanovic D. Escala para medición del nivel socioeconómico, en el área de la salud. Rev Med Chil 1985; 113: 243-9.

  12. American College of Obstetricians and Gynecologists and American Academy of Pediatrics. Neonatal encephalopathy and cerebral palsy: defining the pathogenesis and pathophysiology. Washington, DC: American College of Obstetrician and Gynecologists; 2003.

  13. Silver RM, Varner MW, Reddy U, Goldenberg R, Pinar H, Conway D, et al. Wor-up of stillbirth: a review of the evidence. Am J Obstet Gynecol 2007; 196: 433-44.

  14. Parry S, Strauss JF. Premature rupture of the fetal membranes. N Engl J Med 1998; 338: 663-70.

  15. Flenady V, Koopmans L, Middleton P, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011; 377: 1331-40.

  16. Heaman MI, Newburn-Cook CV, Green CG, Elliot LJ, Helewa ME. Inadequate prenatal care and its association with adverse pregnancy outcomes: a comparison of indices. BMC Pregnancy Childbirth 2008; 8: 15.

  17. Pérez-Molina JJ, Cobian-López BE, Silva-Maciel CA. Factores de riesgo materno y nacimiento pretérmino en un hospital público del occidente de México. Ginecol Obstet Mex 2004; 72: 142-9.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Invest Clin. 2012;64