Robson S, Chan A, Keane R J, Luke C G
Reproductive Medicine Unit, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2001 Feb;41(1):29-35. doi: 10.1111/j.1479-828x.2001.tb01290.x.
The objective of this study was to determine whether women who have experienced an unexplained stillbirth have a higher risk of adverse perinatal outcomes in subsequent births. We compared 316 subsequent births to women with a previous unexplained stillbirth, with 3160 births to women with no previous history of stillbirth, matched by year of birth, in the period 1987-1997, from the South Australian perinatal database, using logistic regression analysis. There was no increase in the rate of stillbirth and no statistically significant increase in the rate of perinatal death (OR 1.62 [95%CI 0.63-4.20]) or neonatal death, although larger studies are needed to confirm this. However, after adjusting for age, parity, and hospital category of birth, women who had a previous stillbirth had increased incidences in subsequent births of abnormal glucose tolerance or gestational diabetes (a fourfold increase); induction of labour and elective Caesarean section; fetal distress and postpartum haemorrhage; and forceps and emergency Caesarean delivery and preterm birth, which were independent of induction of labour. Gestational age at birth and birthweight were also significantly reduced, suggesting a need for close monitoring of their future pregnancies.
本研究的目的是确定经历过不明原因死产的女性在随后分娩中出现不良围产期结局的风险是否更高。我们将1987年至1997年期间南澳大利亚围产期数据库中316例有不明原因死产史女性的后续分娩情况，与3160例无死产史女性的分娩情况进行了比较，两组按出生年份匹配，采用逻辑回归分析。死产率没有增加，围产期死亡率（比值比1.62 [95%可信区间0.63 - 4.20]）或新生儿死亡率也没有统计学上的显著增加，不过需要更大规模的研究来证实这一点。然而，在对年龄、产次和分娩医院类别进行调整后，有过死产史的女性在随后分娩中出现糖耐量异常或妊娠期糖尿病的发生率增加（增加了四倍）；引产和择期剖宫产；胎儿窘迫和产后出血；以及产钳助产、急诊剖宫产和早产，这些情况与引产无关。出生时的孕周和出生体重也显著降低，这表明需要密切监测她们未来的妊娠情况。
