一项关于产前死产危险因素的多中心病例对照研究。

A multicenter, case-control study on risk factors for antepartum stillbirth.

作者信息

Facchinetti Fabio, Alberico Salvatore, Benedetto Chiara, Cetin Irene, Cozzolino Sabrina, Di Renzo Gian Carlo, Del Giovane Cinzia, Ferrari Francesca, Mecacci Federico, Menato Guido, Tranquilli Andrea L, Baronciani Dante

机构信息

Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

J Matern Fetal Neonatal Med. 2011 Mar;24(3):407-10. doi: 10.3109/14767058.2010.496880. Epub 2010 Jun 29.

DOI:10.3109/14767058.2010.496880

PMID:20586545

Abstract

OBJECTIVE

As the influence of socio-demographic variables, lifestyle and medical conditions on the epidemiology of stillbirth (SB) is modified by population features, we aimed at investigating the role played by these factors on the incidence of SB in a developed country.

STUDY DESIGN

Multivariate logistic regression analysis (OR with 95% CI) was utilized in a prospective multicentre nested case-control study to compare in a 1:2 ratio stillborn of >22 weeks gestation with matched for gestational age live-born (LB) infants. Intrapartum SB were excluded.

RESULTS

Two hundred fifty-four consecutive SBs and 497 LBs were enrolled. Socio-demographic variables were equally distributed. Fetal malformations (7.96, 2.69-23.55), severe intrauterine growth restriction (IUGR) (birthweight ≤ 5(th) %ile) (4.32, 2.27?8.24), BMI > 25 (2.87, 1.90-4.33), and preeclampsia (PE, 0.40, 0.21-0.77) were recognized as independent predictors for SB. At term, only BMI > 25 was associated with SB (7.70, 2.9-20.5).

CONCLUSION

Fetal malformations, severe IUGR and maternal BMI > 25 were associated with a significant increase in the risk of SB; PE presented instead a protective role. Maternal BMI > 25 was the only risk factor for SB identified in term pregnancies.

摘要

目的

由于社会人口统计学变量、生活方式和医疗状况对死产（SB）流行病学的影响会因人群特征而有所改变，我们旨在调查这些因素在一个发达国家中对死产发生率所起的作用。

研究设计

在一项前瞻性多中心巢式病例对照研究中，采用多变量逻辑回归分析（比值比及95%可信区间），以1:2的比例比较妊娠22周以上的死产儿与孕周匹配的活产（LB）婴儿。排除产时死产。

结果

纳入了254例连续的死产儿和497例活产儿。社会人口统计学变量分布均衡。胎儿畸形（7.96，2.69 - 23.55）、严重宫内生长受限（IUGR）（出生体重≤第5百分位数）（4.32，2.27 - 8.24）、体重指数>25（2.87，1.90 - 4.33）和子痫前期（PE，0.40，0.21 - 0.77）被确认为死产的独立预测因素。足月时，只有体重指数>25与死产相关（7.70，2.9 - 20.5）。