Hidalgo-Lopezosa Pedro, Cobo-Cuenca Ana Isabel, Carmona-Torres Juan Manuel, Luque-Carrillo Patricia, Rodríguez-Muñoz Pedro Manuel, Rodríguez-Borrego María Aurora
Departamento de Enfermería, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda Menéndez Pidal s/n, 14004, Córdoba, Spain.
IMIBIC, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Avd. Carlos III s/n, Toledo, Spain.
Arch Gynecol Obstet. 2018 Jun;297(6):1415-1420. doi: 10.1007/s00404-018-4726-4. Epub 2018 Feb 21.
Perinatal mortality has been decreasing in Europe thanks to a reduction in neonatal mortality. The causes of fetal mortality remain poorly studied. The objective was to determine the late fetal mortality rate in Spain in 2015 and the associated factors.
A cross-sectional study was performed using data regarding births in 2015 in Spain extracted from the National Institute of Statistics. Single births at 28 or more weeks of pregnancy were included. The sample comprised 340,371 births. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with the fetal mortality from 28 weeks of pregnancy as the dependent variable.
The total number of late fetal deaths was 884 (2.6 × 1000). The MLR model showed that the following factors were associated with late fetal mortality: birth before 37 weeks of pregnancy (OR 13.1); weight of the newborn < 2500 g (OR 3.22) and ≥ 4000 g (OR 3.36); low training level (OR 2.28); and others, such as African origin, maternal age ≥ 35 years, primiparity and mothers who were single.
The rate of late fetal mortality in Spain has not decreased and has remained at the same level as in 2010. This result is related to prematurity, low birth weight, macrosomia and sociodemographic factors, such as low maternal preparation, mothers of African origin, age ≥ 35 years and mothers who are single. It is necessary to improve the quality and accessibility of prenatal care and the early detection of risk factors.
由于新生儿死亡率的降低，欧洲围产期死亡率一直在下降。胎儿死亡的原因仍研究不足。目的是确定2015年西班牙的晚期胎儿死亡率及其相关因素。
采用从国家统计局提取的2015年西班牙出生数据进行横断面研究。纳入妊娠28周及以上的单胎分娩。样本包括340,371例分娩。使用单因素和多因素逻辑回归（MLR）分析社会人口统计学、产科和新生儿变量，以妊娠28周后的胎儿死亡率作为因变量。
晚期胎儿死亡总数为884例（2.6×1000）。MLR模型显示，以下因素与晚期胎儿死亡率相关：妊娠37周前出生（比值比13.1）；新生儿体重<2500g（比值比3.22）和≥4000g（比值比3.36）；文化程度低（比值比2.28）；以及其他因素，如非洲裔、母亲年龄≥35岁、初产和单身母亲。
西班牙晚期胎儿死亡率没有下降，仍维持在2010年的水平。这一结果与早产、低出生体重、巨大儿以及社会人口统计学因素有关，如母亲准备不足、非洲裔母亲、年龄≥35岁和单身母亲。有必要提高产前护理的质量和可及性以及早期发现危险因素。
