Alessandri L M, Stanley F J, Garner J B, Newnham J, Walters B N
Western Australian Research Institute for Child Health, Perth.
Br J Obstet Gynaecol. 1992 Sep;99(9):711-8. doi: 10.1111/j.1471-0528.1992.tb13868.x.
To ascertain factors that will identify women who are at increased risk of unexplained antepartum stillbirth.
Matched case-control study. The cases and controls were initially analysed as a whole group and again after dichotomizing into those of low birthweight (< 2500 g) and those of normal birthweight (> or = 2500 g).
Western Australia 1980-1983.
Unexplained antepartum stillbirths of > or = 1000 g birthweight (cases) and liveborn infants individually matched for year of birth, plurality, sex and birthweight of infant and race of mother (controls).
The case pregnancies had more polyhydramnios (OR 10.83, 95% CI 2.41-48.69) and cord problems (OR 6.57 95% CI 1.36-31.75) than the controls but, paradoxically, other obstetric and medical complications were less common in the cases. The association with polyhydramnios persisted when the analysis was confined to those with low birthweight. With normal birthweight fetal distress was more frequent in the cases (OR 3.65 95% CI 1.36-9.80) but there were few other differences.
The clinical and diagnostic systems currently in use are unable to identify many fetuses at risk of death. Decreases in the rate of unexplained antepartum stillbirths await the discovery of new preventable causes, or of innovations in clinical or laboratory aspects of obstetric care.
确定可识别不明原因产前死产风险增加的女性的因素。
配对病例对照研究。病例和对照最初作为一个整体组进行分析，在分为低出生体重儿（<2500克）和正常出生体重儿（≥2500克）后再次进行分析。
西澳大利亚州，1980 - 1983年。
出生体重≥1000克的不明原因产前死产儿（病例）以及根据出生年份、产次、婴儿性别、出生体重和母亲种族进行个体匹配的活产婴儿（对照）。
与对照组相比，病例组妊娠羊水过多（比值比10.83，95%可信区间2.41 - 48.69）和脐带问题（比值比6.57，95%可信区间1.36 - 31.75）更多，但矛盾的是，病例组其他产科和医学并发症较少见。当分析仅限于低出生体重儿患者时，与羊水过多的关联仍然存在。对于正常出生体重儿，病例组胎儿窘迫更常见（比值比3.65，95%可信区间1.36 - 9.80），但其他差异较少。
目前使用的临床和诊断系统无法识别许多有死亡风险的胎儿。不明原因产前死产率的降低有待发现新的可预防原因，或产科护理临床或实验室方面的创新。
