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


Almeida, MF; Alencar, GP; Novaes, HM; França Jr, I; Siqueira, AA; Campbell, OM; Schoeps, D; Rodrigues, LC; (2007) Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil. Revista de saude publica, 41 (1). pp. 35-43. ISSN 0034-8910 DOI: https://doi.org/10.1590/S0034-89102007000100006

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Abstract

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.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Centre for Global Non-Communicable Diseases (NCDs)
Maternal Health Group
PubMed ID: 17273632
URI: http://researchonline.lshtm.ac.uk/id/eprint/10184

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