Lammer E J, Brown L E, Anderka M T, Guyer B
Division of Family Health Services, Massachusetts Department of Public Health, Boston.
JAMA. 1989;261(12):1757-62.
Fetal deaths, in contrast to infant deaths, have been subject to epidemiologic analysis infrequently. We characterized 574 Massachusetts resident fetal deaths from 1982 and assessed the accuracy of cause-of-death information available from vital records compared with that from corresponding fetal autopsies. The fetal death rate exceeded the neonatal mortality rate. Fetal mortality was higher among black, unmarried, and older mothers. Fetuses of multiple-gestation pregnancies had an unusually high risk of fetal death. Autopsy reports were obtained for 61% of fetal deaths. The underlying cause of death from the fetal death record differed from that on the autopsy report in 55% of cases. Systematic collection of population-based autopsy data is a useful approach for improving the quality and accuracy of mortality statistics on fetal deaths. Many stillbirths remain unexplained, however, and research is needed to identify pathological markers that might reduce the heterogeneity within the fetal deaths currently ascribed to unknown causes.
与婴儿死亡不同，胎儿死亡很少接受流行病学分析。我们对1982年马萨诸塞州居民的574例胎儿死亡进行了特征描述，并评估了生命记录中死因信息与相应胎儿尸检信息相比的准确性。胎儿死亡率超过新生儿死亡率。黑人、未婚和年龄较大的母亲中胎儿死亡率较高。多胎妊娠的胎儿有异常高的胎儿死亡风险。61%的胎儿死亡获得了尸检报告。在55%的病例中，胎儿死亡记录中的根本死因与尸检报告中的不同。系统收集基于人群的尸检数据是提高胎儿死亡死亡率统计质量和准确性的有用方法。然而，许多死产原因仍不明，需要开展研究以确定可能减少目前归因于不明原因的胎儿死亡异质性的病理标志物。
