Pérez-Molina Jesús, Quezada-López Claudia, Panduro-Barón Guadalupe, Castro-Hernández Juan Francisco
División de Pediatría y de Ginecología y Obstetricia, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" y Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara.
Rev Invest Clin. 2012 Jul-Aug;64(4):330-5.
Mortality rates in preterm births and stillbirth are high.
To identify maternal risk factors relating to stillbirth in preterm infants.
We conducted a cross-sectional, analytic study of 1,022 newborns between 20 and 36 weeks of gestation, from September 2004 to August 2005. Stillbirth was defined as fetal death prior to expulsion or extraction from the mother. Data was collected prospectively by directly interviewing the pregnant women and from the medical chart. The dependent variable was stillbirth and the independent ones were the maternal risk factors. Associations were evaluated by logistic regression. RESULTS. One thousand and twenty-four (1,024) preterm births were detected in a total of 14,882 births (6.9%/year). One hundred and fifty-two (152) were stillborn and 870 were live births. The fetal mortality rate was 10.3 per 1,000 live births. The least common maternal factors associated to stillbirth included: urinary tract infection (22/152, 14% vs. 224/869, 26%, p = 0.020), PMR > 24 h (18/152, 12% vs. 172/869, 20%, p = 0.020) and cesarean delivery (24/138, 17% vs. 344/719, 48%, p < 0.001). The crude odd risk ratios for stillbirth included spontaneous preterm delivery (OR 4.38, CI95% 2.70-7.17) and deficient prenatal care (OR 2.64, CI95% 1.83-3.82). By multivariate analysis, stillbirth predictors included: spontaneous preterm delivery (OR 4.00, CI 95% 2.61-6.61) and deficient prenatal care (OR 2.54, CI 95% 1.78-3.62).
Deficient prenatal care was the only statistically significant and clinically coherent variable predicting stillbirth.
早产和死产的死亡率很高。
确定与早产死产相关的母体危险因素。
我们对2004年9月至2005年8月期间1022例妊娠20至36周的新生儿进行了一项横断面分析研究。死产定义为胎儿在从母体排出或取出之前死亡。数据通过直接采访孕妇和查阅病历前瞻性收集。因变量是死产，自变量是母体危险因素。通过逻辑回归评估关联。结果。在总共14882例分娩中检测到1024例早产（6.9%/年）。152例为死产，870例为活产。胎儿死亡率为每1000例活产10.3例。与死产相关的最不常见母体因素包括：尿路感染（22/152，14%对224/869，26%，p = 0.020）、胎膜早破>24小时（18/152，12%对172/869，20%，p = 0.020）和剖宫产（24/138，17%对344/719，48%，p < 0.001）。死产的粗比值比包括自发早产（OR 4.38，CI95% 2.70 - 7.17）和产前检查不足（OR 2.64，CI95% 1.83 - 3.82）。通过多变量分析，死产预测因素包括：自发早产（OR 4.00，CI 95% 从2.61到6.61）和产前检查不足（OR 2.54，CI 95% 1.78 - 3.62）。
产前检查不足是预测死产的唯一具有统计学意义且临床相关的变量。
