Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland.
Int J Gynaecol Obstet. 2018 Jan;140(1):73-80. doi: 10.1002/ijgo.12342. Epub 2017 Oct 28.
To examine the effect of pregnancy history on the risk of stillbirth.
In a population-based cross-sectional study, data were reviewed from all women aged at least 20 years with singleton pregnancies in Finland between 2000 and 2010. The primary outcome-stillbirth-was defined as fetal death after 22 gestational weeks or death of a fetus weighing at least 500 g.
Among 604 047 singleton pregnancies, the prevalence of stillbirth was 3.17 per 1000 deliveries. Prevalence was lowest for multiparous women without previous pregnancy loss after adjusting for major pregnancy complications associated with stillbirth (placenta previa, placental abruption, and pre-eclampsia) and other confounders. Relative to these women, stillbirth prevalence was higher among multiparous women with previous spontaneous abortion and/or stillbirth (adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.05-1.36), nulliparous women with no previous pregnancy loss (aOR 1.23, 95% CI 1.10-1.38), and nulliparous women with prior spontaneous abortion (aOR 1.43, 95% CI 1.18-1.74).
Previous pregnancy loss was found to be an independent risk factor for stillbirth, irrespective of the number of prior deliveries.
探讨妊娠史对死胎风险的影响。
在一项基于人群的横断面研究中，对 2000 年至 2010 年间芬兰所有至少 20 岁且怀有单胎妊娠的女性进行了数据回顾。主要结局——死胎——定义为孕 22 周后胎儿死亡或体重至少 500 克的胎儿死亡。
在 604047 例单胎妊娠中，死胎的发生率为每 1000 例分娩 3.17 例。在调整与死胎相关的主要妊娠并发症（前置胎盘、胎盘早剥和子痫前期）和其他混杂因素后，多产妇且既往无妊娠丢失的死胎发生率最低。与这些女性相比，既往有自发性流产和/或死胎的多产妇（调整后的优势比 [aOR] 1.20，95%置信区间 [CI] 1.05-1.36）、既往无妊娠丢失的初产妇（aOR 1.23，95% CI 1.10-1.38）和既往有自发性流产的初产妇（aOR 1.43，95% CI 1.18-1.74）的死胎发生率更高。
无论既往分娩次数如何，既往妊娠丢失均被发现是死胎的独立危险因素。
