Document Detail

Developing interventions to target modifiable risk factors in pregnancy losses in Philadelphia.
MedLine Citation:
PMID:  24770251     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: Philadelphia has one of the highest neonatal mortality rates in the country. It is believed that stillbirth rates are closely associated with neonatal mortality rates. Modifiable risk factors associated with intrauterine fetal demise are population-specific. We conducted this study to identify appropriate population-specific modifiable risk factors to improve fetal and neonatal mortality rates.
METHODS: A retrospective chart review study was preformed of 65 women that delivered at Temple University Health System with an intrauterine fetal demise at 28 weeks of gestation or greater between 2008 and 2013. Obstetric and demographic data were collected from charts and compared with a control group representing the general population in northeast Philadelphia.
RESULTS: Drug use (34%), placental abruption (22%), preeclampsia (14.3%), and anemia (88%) were higher in the intrauterine fetal demise group compared with the general population. Mental health disorders were common in this single, African American population with little to no insurance (intrauterine fetal demise group). Decreased fetal movements (60.8%) followed by vaginal bleeding (21.6%) and fluid loss (7.8%) were the most frequent complaints.
CONCLUSION: Patients who lack social support and have mental and emotional instability are at increased risk for turning to drugs and alcohol. This leaves the patient crippled and incapable of making sound decisions for during pregnancy. For this population, a different approach must be taken to alleviate and hopefully reduce these numbers, because many of these factors are modifiable. Targeted education, access to prenatal care, availability of mental health centers, and drug rehabilitation programs are recommended.
Dimitrios Mastrogiannis; Jessica Barker
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  123 Suppl 1     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  69S     Citation Subset:  AIM; IM    
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