Kumar R, Singhi S
Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh.
Indian J Pediatr. 1992 Jul-Aug;59(4):455-61. doi: 10.1007/BF02751561.
To determine the risk factors for stillbirth, a case-control study was carried out in a rural community of Haryana. Stillbirths (cases) were identified retrospectively from a household survey, while the controls, matched individually with each case for the month of birth, were live born infants from the same neighbourhood as the case. The stillbirth rate in the study population was 26.8 per 1000 (68/2539) births. The distribution of socio-economic and environmental factors was similar in the cases and the controls (P > 0.05). Multivariate analysis indicated higher risk of stillbirth for first order births (Odds Ratio [OR] 7.9, Confidence Interval [CI] 2.1-29.2, P 0.002), history of prior stillbirths/child deaths (OR 15.2, CI 2.3-98.2, P 0.004), and absence of antenatal care (OR 3.3, CI 0.9-14.3, P 0.07). Mothers' age, birth interval (< 24 months), delivery place (hospital or home) and type of birth attendant (trained vs untrained) did not show significant influence on the risk of stillbirth. An improvement in the coverage of antenatal care in socio-economically weaker rural community is suggested as the most appropriate strategy for reducing the high stillbirth rate.
为确定死产的风险因素，在哈里亚纳邦的一个农村社区开展了一项病例对照研究。通过家庭调查回顾性地确定死产（病例），而对照则是与每个病例按出生月份进行个体匹配的、来自与病例相同社区的活产婴儿。研究人群中的死产率为每1000例出生中有26.8例（68/2539）。社会经济和环境因素在病例组和对照组中的分布相似（P>0.05）。多变量分析表明，初产的死产风险较高（优势比[OR]7.9，置信区间[CI]2.1 - 29.2，P 0.002），既往有死产/儿童死亡史（OR 15.2，CI 2.3 - 98.2，P 0.004），以及未接受产前护理（OR 3.3，CI 0.9 - 14.3，P 0.07）。母亲年龄、生育间隔（<24个月）、分娩地点（医院或家中）以及接生人员类型（经过培训与未经过培训）对死产风险未显示出显著影响。建议改善社会经济较薄弱农村社区的产前护理覆盖率，作为降低高死产率的最合适策略。
