Document Detail


The association between stillbirth in the first pregnancy and subsequent adverse perinatal outcomes.
MedLine Citation:
PMID:  19691947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We sought to examine the association between first-pregnancy stillbirth and subsequent adverse perinatal outcomes. STUDY DESIGN: This cohort study examined the first 2 singleton deliveries at 20-44 weeks' gestation from 1991-2008 (n = 71,315) using birth certificate, hospitalization, and outpatient encounter files. Multivariable logistic regression models were used to assess the association. RESULTS: Stillbirth was observed in 5.3 of 1000 first deliveries. There was an increased risk of ischemic placental disease (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2-2.1), fetal distress (OR, 2.8; 95% CI, 1.7-4.5), chorioamnionitis (OR, 2.3; 95% CI 1.5-4.3), extreme preterm birth (OR, 4.2; 95% CI, 1.8-9.9), and early neonatal mortality (OR, 8.3; 95% CI, 3.7-18.6) in pregnancies after stillbirth vs pregnancies after live birth. Interpregnancy intervals <2 and > or =4 years after stillbirth increased the risk of ischemic placental disease and spontaneous preterm birth. Risks varied by stillbirth subtype. CONCLUSION: A first-pregnancy stillbirth may increase adverse perinatal outcomes in subsequent pregnancy.
Authors:
Darios Getahun; Jean M Lawrence; Michael J Fassett; Daniel Strickland; Corinna Koebnick; Wansu Chen; Steven J Jacobsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-18
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  201     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-30     Completed Date:  2009-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  378.e1-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Research and Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA 91101, USA. Darios.T.Getahun@kp.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorioamnionitis / epidemiology
Female
Fetal Distress / epidemiology
Gestational Age
Humans
Logistic Models
Pregnancy
Pregnancy Outcome*
Stillbirth / epidemiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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