Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

Revista de Saúde Pública

Marcia Furquim De Almeida²  Gizelton Pereira Alencar²  Hillegonda Maria Dutilh Novaes¹  Ivan França Jr¹  Arnaldo Augusto Franco De Siqueira¹  Oona M R Campbell¹  Daniela Schoeps²  Laura Cunha Rodrigues¹ 

[1] ,Universidade de São Paulo Faculdade de Saúde Pública Departamento de EpidemiologiaSão Paulo SP ,Brasil

关键词: Antepartum fetal death;    Prenatal care;    Risk factors;    Socioeconomic factors;    Case-control study;    Pregnancy;    Óbito fetal anteparto;    Atenção pré-natal;    Fatores de risco;    Fatores socioeconômicos;    Estudo de casos e controle;    Gravidez;   

DOI  :  10.1590/S0034-89102007000100006

来源: SciELO

【 摘 要 】

OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.

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