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  • 标题:Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil
  • 本地全文:下载
  • 作者:Marcia Furquim de Almeida ; Gizelton Pereira Alencar ; Hillegonda Maria Dutilh Novaes
  • 期刊名称:Revista de Saúde Pública
  • 印刷版ISSN:0034-8910
  • 出版年度:2007
  • 卷号:41
  • 期号:1
  • 页码:35-43
  • 语种:English
  • 出版社:Universidade de São Paulo
  • 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.
  • 其他摘要: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.
  • 关键词:Antepartum fetal death; Prenatal care; Risk factors;Socioeconomic factors; Case-control study; Pregnancy.
  • 其他关键词:Antepartum fetal death; Prenatal care; Risk factors;Socioeconomic factors; Case-control study; Pregnancy.
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