Document Detail


Changes in fetal death during 40 years-different trends for different gestational ages: a population-based study in Norway.
MedLine Citation:
PMID:  21176089     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Please cite this paper as: Sarfraz A, Samuelsen S, Eskild A. Changes in fetal death during 40 years-different trends for different gestational ages: a population-based study in Norway. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02819.x. Objective  To study changes in gestational-age-specific fetal death risks during a 40-year period. Design  Register-based observational study. Setting  The Medical Birth Registry of Norway. Population  All pregnancies after 16 weeks of gestation in Norway from 1967 to 2006 (n = 2 182 756). Method  Changes in fetal death risk since 1967-1971 (reference) were estimated as absolute risks (rates) and relative risks (RR) in ongoing pregnancies at the following gestational weeks; 16-22, 23-29, 30-36 and 37-43. Main outcome measures  Fetal death. Results  In all pregnancies lasting longer than 22 weeks, the fetal death rate decreased during 1967-2006. The greatest decline was in term pregnancies (37-43 weeks) from 10.8 to 3.3 fetal deaths per 1000 at risk (crude RR 0.35; 95% CI 0.31-0.38) comparing 1967-1971 with 2002-2006. In pregnancies at 30-36 weeks the fetal death rate declined from 4.5 to 1.1 per 1000 (crude RR 0.23; 95% CI 0.21-0.26). At 23-29 weeks, the rate declined from 2.8 to 1.3 per 1000 (crude RR 0.46; 95% CI 0.40-0.52). An opposite trend was observed at early gestation (16-22 weeks) with an increase from 1.7 to 3.4 fetal deaths per 1000 ongoing pregnancies (crude RR 2.05; 95% CI 1.84-2.27). Adjustments for maternal age, parity, multiple pregnancies, paternal age and pre-eclampsia did not significantly alter the estimated associations. Conclusion  Since 1967 the risk of fetal death has been reduced by almost 70% in pregnancies lasting longer than 22 weeks; however, at 16-22 weeks of gestation there was an increase in risk. The causes of this increase should be further explored because it may be attributed to an increase in early delivery caused by the increased proportion of women being treated with cervical cone excision before pregnancy.
Authors:
Aa Sarfraz; So Samuelsen; A Eskild
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-23
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  -     ISSN:  1471-0528     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.
Affiliation:
Department of Obstetrics and Gynaecology and Medical Faculty Division, Akershus University Hospital, Lørenskog, Norway Department of Mathematics, University of Oslo, Oslo, Norway Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
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