Panduro Barón J Guadalupe, Vázquez Granados María Dolores, Pérez Molina J Jesús, Castro Hernández Juan Francisco
Unidad de Medicina Fetal de la División de Ginecologia y Obstericia, Hopital Civil de Guadalajara, México.
Ginecol Obstet Mex. 2006 Nov;74(11):573-9.
To identify the sociodemographics, obstetrical and perinatology factors of risk most frequently associated to fetal death in greater pregnancies of 27 weeks.
From January 2001 to May 2005, in the Hospital Civil de Guadalajara Dr Juan I. Menchaca, we carried out a study of cases and controls with 450 cases of fetal death of more than 27 weeks of gestation and 450 newborn alive whose birth happened immediately later. We compared the frequency of different maternal and fetal variables that in previous forms was associated with fetal death, by means of Chi squared test and exact test of Fisher, the association among these variables and fetal death with the reason of momios was considered. In all the cases the chosen interval of confidence was of 95%.
The risk factors associated with fetal death were: maternal age over 35 years, low schooling, multiparity, antecedent of abortion and fetal death, deficient prenatal care, complications in the pregnancy, abnormal amniotic fluid, double circular of umbilical cord to neck of the product and great congenital malformations of newborn. It was not associated with fetal death, the single marital status, primigesta, smoking, male sex of the fetus, simple circulate of umbilical cord to the neck and fetal macrosomia.
Of the risk factors associated with fetal death, the main one is a deficient prenatal care, that of being improved, might diminish the association of some other variables that were associated with fetal death.
确定孕27周及以上较大孕周胎儿死亡最常相关的社会人口统计学、产科和围产医学风险因素。
2001年1月至2005年5月,在瓜达拉哈拉胡安·I·门查卡公民医院,我们对病例和对照进行了一项研究,其中有450例孕27周以上的胎儿死亡病例以及450例随后立即出生的存活新生儿。我们通过卡方检验和费舍尔精确检验比较了先前形式中与胎儿死亡相关的不同母体和胎儿变量的频率,并考虑了这些变量与胎儿死亡及死胎原因之间的关联。在所有病例中,选定的置信区间为95%。
与胎儿死亡相关的风险因素有:母亲年龄超过35岁、受教育程度低、多胎妊娠、有流产和胎儿死亡史、产前护理不足、妊娠并发症、羊水异常、脐带绕胎儿颈部两周及新生儿严重先天性畸形。与胎儿死亡无关的因素有:单身婚姻状况、初产妇、吸烟、胎儿为男性、脐带绕胎儿颈部一周及胎儿巨大。
在与胎儿死亡相关的风险因素中,主要因素是产前护理不足,若能改善产前护理,可能会减少一些其他与胎儿死亡相关变量之间的关联。