Faculty of Biology, Medicine and Health, Maternal and Fetal Health Research Centre, School of Medical Sciences, University of Manchester, Manchester, UK.
St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.
BJOG. 2021 Mar;128(4):704-713. doi: 10.1111/1471-0528.16543. Epub 2020 Oct 28.
To investigate behavioural and social characteristics of women who experienced a late stillbirth compared with women with ongoing live pregnancies at similar gestation.
Case-control study.
41 maternity units in the UK.
Women who had a stillbirth ≥28 weeks' gestation (n = 287) and women with an ongoing pregnancy at the time of interview (n = 714).
Data were collected using an interviewer-administered questionnaire which included questions regarding women's behaviours (e.g. alcohol intake and household smoke exposure) and social characteristics (e.g. ethnicity, employment, housing). Stress was measured by the 10-item Perceived Stress Scale.
Late stillbirth.
Multivariable analysis adjusting for co-existing social and behavioural factors showed women living in the most deprived quintile had an increased risk of stillbirth compared with the least deprived quintile (adjusted odds ratio [aOR] 3.16; 95% CI 1.47-6.77). There was an increased risk of late stillbirth associated with unemployment (aOR 2.32; 95% CI 1.00-5.38) and women who declined to answer the question about domestic abuse (aOR 4.12; 95% CI 2.49-6.81). A greater number of antenatal visits than recommended was associated with a reduction in stillbirth (aOR 0.26; 95% CI 0.16-0.42).
This study demonstrates associations between late stillbirth and socio-economic deprivation, perceived stress and domestic abuse, highlighting the need for strategies to prevent stillbirth to extend beyond maternity care. Enhanced antenatal care may be able to mitigate some of the increased risk of stillbirth.
Deprivation, unemployment, social stress & declining to answer about domestic abuse increase risk of #stillbirth after 28 weeks' gestation.
调查经历晚期死胎的女性与同期有持续活产妊娠的女性的行为和社会特征。
病例对照研究。
英国 41 家产科单位。
≥28 周妊娠的死胎产妇（n=287）和同期接受访谈的活产孕妇（n=714）。
采用访谈者管理的问卷调查收集数据，内容包括女性行为（如饮酒和家庭吸烟暴露）和社会特征（如种族、就业、住房）。压力用 10 项感知压力量表测量。
晚期死胎。
多变量分析调整了共存的社会和行为因素，结果显示，与最不贫困五分位数相比，最贫困五分位数的女性死胎风险增加（调整后的优势比[aOR] 3.16；95%可信区间[CI] 1.47-6.77）。失业与晚期死胎的风险增加相关（aOR 2.32；95% CI 1.00-5.38），拒绝回答关于家庭虐待问题的女性（aOR 4.12；95% CI 2.49-6.81）的死胎风险也增加。与推荐的产前就诊次数相比，就诊次数较多与死胎减少相关（aOR 0.26；95% CI 0.16-0.42）。
本研究表明，晚期死胎与社会经济剥夺、感知压力和家庭虐待有关，这突出表明需要制定策略来预防死胎，而不仅仅局限于产科护理。强化产前保健可能能够减轻一些增加的死胎风险。
剥夺、失业、社会压力和拒绝回答关于家庭虐待的问题会增加 28 周后#死胎的风险。
