Frøen J Frederik, Møyland Randi A, Saugstad Ola Didrik, Stray-Pedersen Babill
Department of Obstetrics & Gynecology, Rikshospitalet University Clinic, University of Oslo, Oslo, Norway.
Obstet Gynecol. 2002 Nov;100(5 Pt 1):909-15.
To study the impact of maternal health and obstetric complications on the risk for sudden intrauterine unexplained death.
All 76 cases of sudden intrauterine unexplained death and 165 explained stillbirths among singletons in Oslo, Norway (1986-1995) were compared with 582 controls. Information on maternal health was registered from antenatal health cards and the Medical Birth Registry of Norway. The effect of pregnancy duration was studied before logistic regression analysis corrected for pregnancy duration was performed.
Urinary tract colonization or infection in pregnancy was associated with a reduced risk for subsequent sudden intrauterine unexplained death (odds ratio [OR] 0.29 [0.12-0.74]), whereas insufficient physiologic hemodilution during pregnancy (lowest hemoglobin greater than 13 g/mL) increased the risk for sudden intrauterine unexplained death (OR 9.50 [1.30-69.3]). However, the risk for sudden intrauterine unexplained death remained unaffected by the total number of indicators of impaired maternal health during pregnancy, in contrast to significant impact on other stillbirths.
Urinary tract colonization or infection may offer protection against sudden intrauterine unexplained death. We hypothesize that the subsequent maternal immune response offers transplacental protection against lethal fetal infections by common pathogens of urinary tract infections. Other health indicators have little impact on sudden intrauterine unexplained death.
研究孕产妇健康及产科并发症对不明原因的宫内猝死风险的影响。
将挪威奥斯陆1986 - 1995年单胎妊娠中76例不明原因的宫内猝死病例及165例死因明确的死产病例与582例对照进行比较。孕产妇健康信息来自产前健康卡及挪威医疗出生登记处。在进行校正妊娠时长的逻辑回归分析之前，先研究了妊娠时长的影响。
孕期尿路定植或感染与随后不明原因的宫内猝死风险降低相关（优势比[OR] 0.29 [0.12 - 0.74]），而孕期生理性血液稀释不足（最低血红蛋白大于13 g/mL）会增加不明原因的宫内猝死风险（OR 9.50 [1.30 - 69.3]）。然而，与对其他死产的显著影响相反，孕期孕产妇健康受损指标总数对不明原因的宫内猝死风险没有影响。
尿路定植或感染可能对不明原因的宫内猝死起到保护作用。我们推测，随后的母体免疫反应可通过尿路感染的常见病原体为胎儿提供经胎盘的保护，防止致命的胎儿感染。其他健康指标对不明原因的宫内猝死影响不大。
