Isaksen C V, Laurini R N, Jacobsen G
Department of Pathology, Norwegian University of Science and Technology, Trondheim, Norway.
Acta Obstet Gynecol Scand Suppl. 1997;165:44-9.
The Scandinavian part of the NICHD study of successive small-for-gestational-age (SGA) births included 5722 parous women from Trondheim and Bergen (in Norway) and Uppsala (in Sweden). Study enrollment took place from January 1986 through March 1988. The aim of the main study was to investigate factors associated with inhibited intrauterine growth. This paper reports on the fetal, perinatal, and neonatal deaths among the births in the study in relation to different risk factors. The cause of deaths were analyzed to see if there were any associations with the risk factors. There was a total of 84 deaths, 65 of these were fetal, perinatal or neonatal deaths and included in this analysis. The remaining 19 are for different reasons excluded. Thirty-two (60%) of the autopsies regarded the high risk group who comprised only 42.4% of the total study population. The high risk group was selected using the following risk criteria: a previous low weight birth or perinatal death, maternal low weight (pre-pregnancy weight < 50 kg), the presence of a chronic maternal disease, and smoking at the time of conception. A significant association was found between perinatal mortality and the presence of one or more of the defined risk criteria (relative risk 2.0; 95% CI 1.2, 3.4). Asphyxia and related disorders was the most important single cause of death and was found to be associated with the maternal risk factors (RR 3.9; 95% CI 1.5, 9.8). A significant association was found between maternal risk factors and SGA autopsies (RR 3.9; 95% CI 1.7, 8.9). No association was found between asphyxia and SGA. It is concluded that women with risk factors based on complications in a previous pregnancy are more prone to stillbirths, perinatal, and neonatal deaths, and with asphyxia as the most prominent cause of death.
美国国立儿童健康与人类发展研究所（NICHD）针对连续小于胎龄儿（SGA）出生情况开展的研究中，斯堪的纳维亚地区部分涵盖了来自挪威特隆赫姆和卑尔根以及瑞典乌普萨拉的5722名经产妇。研究入组时间为1986年1月至1988年3月。主要研究目的是调查与子宫内生长受限相关的因素。本文报告了该研究中出生儿的胎儿、围产期及新生儿死亡情况与不同风险因素的关系。对死亡原因进行分析，以查看是否与风险因素存在任何关联。总共有84例死亡，其中65例为胎儿、围产期或新生儿死亡并纳入本分析。其余19例因不同原因被排除。32例（60%）尸检针对高危组，该组仅占总研究人群的42.4%。高危组根据以下风险标准选取：既往低体重出生或围产期死亡、母亲体重低（孕前体重<50千克）、母亲患有慢性疾病以及受孕时吸烟。发现围产期死亡率与一种或多种既定风险标准之间存在显著关联（相对风险2.0；95%置信区间1.2, 3.4）。窒息及相关病症是最重要的单一死亡原因，且发现与母亲风险因素相关（相对风险3.9；95%置信区间1.5, 9.8）。发现母亲风险因素与SGA尸检之间存在显著关联（相对风险3.9；95%置信区间1.7, 8.9）。未发现窒息与SGA之间存在关联。得出的结论是，基于既往妊娠并发症存在风险因素的女性更易发生死产、围产期及新生儿死亡，且窒息是最主要的死亡原因。
