Yildirim Gökhan, Aşicioğlu Osman, Güngördük Kemal, Turan Işıl, Acar Deniz, Aslan Halil, Günay Taner
Department of Obstetrics and Gynecology, Kanuni Sultan Süleyman Teaching Hospital , İstanbul , Turkey .
J Matern Fetal Neonatal Med. 2014 Jul;27(10):1029-32. doi: 10.3109/14767058.2013.849687. Epub 2013 Oct 31.
We aimed to determine whether the risks of adverse outcomes were greater in women who had pregnancies ending in stillbirth than in those with no previous history of stillbirth.
This retrospective cohort study included all women who had undergone their first and second deliveries at Bakirkoy Women's and Children's Education and Research Hospital between 2002 and 2011. Women who delivered following a previous stillbirth after 20 complete weeks of gestation were compared with those who had delivered but had no history of stillbirth after 20 weeks of gestation.
We compared 201 subsequent births to women with previous histories of stillbirth with 402 live births to women with no such history. The rates of pre-eclampsia [odds ratio (OR), 3.4; 95% confidence interval (CI), 1.5-7.4], HELLP syndrome (OR, 3.1; 95% CI, 1.2-9.6), low birth weight (OR, 1.6; 95% CI, 0.7-3.5) and malpresentation (OR, 2.9; 95% CI, 1.6-4.8) were significantly higher in the case group. Howewer, the rates of stillbirth were similar between the groups.
We found increased rates of obstetric and perinatal complications in subsequent pregnancies in women with histories of stillbirth. Thus, the results of this study suggest that pregnant women with histories of stillbirth should be followed closely, beginning in the early gestational period.
我们旨在确定死产结束妊娠的女性出现不良结局的风险是否高于既往无死产史的女性。
这项回顾性队列研究纳入了2002年至2011年间在巴基尔科伊妇女儿童教育与研究医院进行首次和第二次分娩的所有女性。将妊娠20周后既往有死产史且分娩的女性与妊娠20周后分娩但无死产史的女性进行比较。
我们将201例既往有死产史女性的后续分娩与402例无此病史女性的活产进行了比较。子痫前期[比值比（OR），3.4；95%置信区间（CI），1.5 - 7.4]、HELLP综合征（OR，3.1；95%CI，1.2 - 9.6）、低出生体重（OR，1.6；95%CI，0.7 - 3.5）和胎位异常（OR，2.9；95%CI，1.6 - 4.8）的发生率在病例组中显著更高。然而，两组之间的死产率相似。
我们发现既往有死产史的女性在后续妊娠中产科和围产期并发症的发生率增加。因此，本研究结果表明，既往有死产史的孕妇应从妊娠早期开始密切随访。
