Rivera Leonor, Fuentes Román María de Lourdes, Esquinca Albores Carlos, Javier Abarca Francisco, Hernández Girón Carlos
Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Rev Saude Publica. 2003 Dec;37(6):687-92. doi: 10.1590/s0034-89102003000600001. Epub 2003 Nov 27.
To identify socioeconomic, gynecological-obstetric and fetal factors associated with perinatal mortality.
A matched case-control study was carried out. Cases were newborns (born live or dead) that were born and died between 28 weeks gestation and 7 days of life. Controls were live newborns between 28 weeks gestation and 7 days of life. A total of 99 cases and 197 controls were studied. Data were obtained from the corresponding medical charts. Statistical analysis was performed using Stata 6.0 software.
Mean maternal age was 24.82 years and mean newborn age was 37.78 weeks gestation with an average birth weight of 2,760 grams. Factors associated with perinatal mortality were: father's occupation as a farmer (adjusted odds ratio (OR)=3.31; 95% CI=1.26-8.66); high obstetric risk index (adjusted OR=10.57; 95% CI=2.82-39.66), cesarean birth (adjusted OR=2.75; 95% CI=1.37-5.51), five or more prenatal visits (adjusted OR=4.43; 95% CI=1.86-10.54) and preterm fetal maturity indices (PEG, APG, GEG) (adjusted OR=9.20; 95% CI=4.39-19.25).
The risk factors associated with perinatal mortality found in the study are consistent with the findings reported in the international literature. These results show that prevention and control measures should be implemented to identify at risk pregnant women in order to lower perinatal mortality.
确定与围产期死亡率相关的社会经济、妇产科和胎儿因素。
开展一项匹配病例对照研究。病例为妊娠28周及出生后7天内出生并死亡的新生儿(活产或死产)。对照为妊娠28周及出生后7天内的活产新生儿。共研究了99例病例和197例对照。数据从相应的病历中获取。使用Stata 6.0软件进行统计分析。
母亲平均年龄为24.82岁,新生儿平均胎龄为37.78周,平均出生体重为2760克。与围产期死亡率相关的因素有:父亲职业为农民(调整优势比(OR)=3.31;95%置信区间(CI)=1.26 - 8.66);高产科风险指数(调整OR = 10.57;95% CI = 2.82 - 39.66),剖宫产(调整OR = 2.75;95% CI = 1.37 - 5.51),五次或更多次产前检查(调整OR = 4.43;95% CI = 1.86 - 10.54)以及早产胎儿成熟指数(PEG、APG、GEG)(调整OR = 9.20;95% CI = 4.39 - 19.25)。
该研究中发现的与围产期死亡率相关的危险因素与国际文献报道的结果一致。这些结果表明,应实施预防和控制措施以识别高危孕妇,从而降低围产期死亡率。