Samueloff A, Xenakis E M, Berkus M D, Huff R W, Langer O
Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio.
J Reprod Med. 1993 Nov;38(11):883-6.
We sought to identify the significance of recurrent stillbirth and to determine the contributory etiologic factors for this phenomenon. Data were analyzed and retrospective chart review conducted for all stillbirths occurring during a 13-year period. Subjects were divided into two groups: those for whom the current stillbirth was the first and those who had had a previous stillbirth. The study included 48,479 consecutive multiparous women, of whom 403 had delivered stillborn infants (8.31/1,000 live births). For 34 of these subjects, this represented a recurrent stillbirth (84.36/1,000 live births). The recurrent-stillbirth group had a 10.15-fold higher risk for stillbirth. Additionally, this group had a twofold higher incidence of diabetes and hypertensive disease than did those women experiencing their first stillbirths; furthermore, the gestational age and birth weight of the stillborn infants were significantly lower in the recurrent-stillbirth group (P < .0004 and < .007, respectively). Such factors as socioeconomic class, chorioamnionitis and erythroblastosis fetalis, traditionally cited as contributing to repeated fetal loss, were not significant. Although recurrent stillbirth remains an unsolved problem, improving health care to specific groups within high-risk populations may reduce fetal loss.
我们试图确定复发性死产的重要性，并确定导致这种现象的病因因素。对13年期间发生的所有死产病例进行了数据分析和回顾性病历审查。将研究对象分为两组：当前死产为首次发生的和曾有过死产经历的。该研究纳入了48479名连续的经产妇，其中403人分娩了死产婴儿（每1000例活产中有8.31例）。在这些研究对象中，有34人经历了复发性死产（每1000例活产中有84.36例）。复发性死产组的死产风险高出10.15倍。此外，该组患糖尿病和高血压疾病的发生率比首次经历死产的女性高出两倍；此外，复发性死产组死产婴儿的孕周和出生体重显著更低（分别为P < 0.0004和< 0.007）。传统上认为导致反复胎儿丢失的社会经济阶层、绒毛膜羊膜炎和胎儿成红细胞增多症等因素并不显著。尽管复发性死产仍然是一个未解决的问题，但改善高危人群中特定群体的医疗保健可能会减少胎儿丢失。
