Document Detail


Epidemiology of fetal death in Latin America.
MedLine Citation:
PMID:  10830764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To identify risk factors associated with fetal death, and to measure the rate and the risk of fetal death in a large cohort of Latin American women. METHODS: We analyzed 837,232 singleton births recorded in the Perinatal Information System Database of the Latin American Center for Perinatology and Human Development (CLAP) between 1985 and 1997. The risk factors analyzed included fetal factors and maternal sociodemographic, obstetric, and clinical characteristics. Adjusted relative risks were obtained, after adjustment for potential confounding factors, through multiple logistic regression models based on the method of generalized estimating equations. RESULTS: There were 14,713 fetal deaths (rate=17.6 per 1000 births). The fetal death risk increased exponentially as pregnancy advanced. Thirty-seven percent of all fetal deaths occurred at term, and 64% were antepartum. The main risk factors associated with fetal death were lack of antenatal care (adjusted relative risk [aRR]=4.26; 95% confidence interval, 3.84-4.71) and small for gestational age (aRR=3.26; 95% CI, 3.13-3.40). In addition, the risk of death during the intrapartum period was almost tenfold higher for fetuses in noncephalic presentations. Other risk factors associated with stillbirth were: third trimester bleeding, eclampsia, chronic hypertension, preeclampsia, syphilis, gestational diabetes mellitus, Rh isoimmunization, interpregnancy interval<6 months, parity > or =4, maternal age > or =35 years, illiteracy, premature rupture of membranes, body mass index > or =29.0, maternal anemia, previous abortion, and previous adverse perinatal outcomes. CONCLUSIONS: There are several preventable factors that should be dealt with in order to reduce the gap in fetal mortality between Latin America and developed countries.
Authors:
A Conde-Agudelo; J M Belizán; J L Díaz-Rossello
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  79     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-12     Completed Date:  2000-06-12     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  371-8     Citation Subset:  IM    
Affiliation:
Latin American Center for Perinatology and Human Development (CLAP), Division of Health Promotion and Protection, PAHO, WHO, Montevideo, Uruguay.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia / complications
Child
Cohort Studies
Diabetes, Gestational / complications
Eclampsia / complications
Educational Status
Female
Fetal Death / epidemiology*,  etiology
Fetal Membranes, Premature Rupture / complications
Humans
Hypertension / complications
Infant, Newborn
Infant, Small for Gestational Age
Latin America / epidemiology
Male
Marital Status
Maternal Age
Pregnancy
Pregnancy Outcome*
Pregnancy, High-Risk
Prenatal Care
Rh-Hr Blood-Group System
Risk Factors
Smoking / adverse effects
Syphilis / complications
Chemical
Reg. No./Substance:
0/Rh-Hr Blood-Group System

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