Alessandri L M, Stanley F J, Newnham J, Walters B N
Western Australian Research Institute for Child Health, Perth.
Early Hum Dev. 1992 Sep;30(2):147-61. doi: 10.1016/0378-3782(92)90142-4.
All antepartum stillbirths weighing 1000 g or more born in Western Australia from 1980 to 1983 were categorised as 'unexplained' or 'explained' based on information from Perinatal Death Certificates. Using data from hospital and doctors' antenatal records a number of variables in each stillbirth category were compared by unconditional logistic regression. Significant differences were observed between the two groups in medical disorders and abnormalities of pregnancy, thus confirming our classification system. Compared with mothers of 'explained' antepartum stillbirths, mothers of unexplained antepartum stillbirths tended to have younger ages at delivery and had associated lower parity, more antenatal visits to the medical practitioner, fewer hospital admissions, a greater chance of having received care by a general practitioner than by a specialist obstetrician and were of more advanced gestation at the time of diagnosis. The results of this study indicate that the epidemiological characteristics of pregnancies resulting in unexplained antepartum stillbirths differ from those resulting in explained antepartum stillbirths. This suggests that unexplained antepartum stillbirths are not merely the result of inadequate obstetrical management but consist of a series of fetal disease states which are not currently amenable to detection.
1980年至1983年在西澳大利亚出生的所有体重1000克及以上的产前死胎，根据围产期死亡证明上的信息被分类为“原因不明”或“原因明确”。利用医院和医生的产前记录数据，通过无条件逻辑回归对每个死胎类别中的一些变量进行了比较。两组在医学疾病和妊娠异常方面存在显著差异，从而证实了我们的分类系统。与“原因明确”的产前死胎的母亲相比，原因不明的产前死胎的母亲分娩时年龄往往较小，产次较低，看医生的产前检查次数较多，住院次数较少，由全科医生而非专科产科医生护理的可能性更大，诊断时孕周更大。本研究结果表明，导致原因不明的产前死胎的妊娠的流行病学特征与导致原因明确的产前死胎的妊娠不同。这表明原因不明的产前死胎不仅仅是产科管理不足的结果，而是由一系列目前无法检测到的胎儿疾病状态组成。
