Risk Factors for Stillbirth in Developing Countries: A Systematic Review of the Literature

Mario, Simona Di; Say, Lale; Lincetto, Ornella

doi:10.1097/01.olq.0000258130.07476.e3

Cited by 120 publications

(142 citation statements)

References 37 publications

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“…Em uma revisão sistemática publicada em 2007, os autores analisaram 33 estudos com informações sobre os fatores de risco para natimortalidade em 31 países em desenvolvimento e calcularam para cada fator um índice correspondendo ao número de eventos ocorridos em uma população, os quais seriam evitados caso o fator de risco fosse removido. A sífilis foi um dos fatores com maior índice, mostrando quão eficazes seriam as estratégias de diagnóstico e rastreamento para reduzir esta importante causa de morte fetal 17 .…”

Section: Discussionunclassified

“…No estudo de Rouquayrol et al 6 , foi verificada uma chance maior de analfabetismo materno (OR=3,3) nos casos de natimortos, e os pontos de corte para avaliação de escolaridade variam entre os diversos estudos 16 . Mesmo em países desenvolvidos, como a Suécia e a Finlândia, é verificada associação entre menor escolaridade e morte fetal 17 . No presente estudo, quando realizamos análise bivariada, testamos diversos pontos de corte para escolaridade, adotandose oito anos por ter sido o que evidenciou diferenças mais importantes em relação à frequência de natimortos.…”

Section: Discussionunclassified

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Fatores associados à natimortalidade em uma maternidade escola em Pernambuco: estudo caso-controle

Andrade¹,

Amorim²,

Cunha³

et al. 2009

Rev. Bras. Ginecol. Obstet.

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A partir do nome e número de registro, foram identificadas as puérperas numa enfermaria de puerpério. Para seleção dos controles, foi obedecido ao critério de vizinhança da enfermaria de puerpério, identificando-se os leitos com numeração imediatamente inferior (duas pacientes) e superior (duas pacientes), desde que tivessem parido nascidos vivos. Caso não concordassem em participar da pesquisa, eram abordadas sucessivamente as numerações de leito consecutivamente menores ou maiores. Para testar a associação entre as variáveis independente (preditoras) e dependente (natimortos), foi utilizado o teste do χ 2 de associação e o exato de Fisher, quando indicado, considerando-se o nível de significância de 5%. Para determinação da força da associação, foi utilizada a estimativa do risco relativo para os estudos de caso-controle, Odds Ratio (OR), calculando seu intervalo de confiança (IC) a 95%. Foi realizada análise de regressão logística seguindo o modelo hierarquizado para controle dos fatores de confusão. RESULTADOS: a taxa de mortalidade fetal correspondeu a 24,4 por 1.000 nascimentos. Depois da análise multivariada, as variáveis que persistiram significativamente associadas ao óbito fetal foram: presença de malformações (OR=7,5; IC=3,2-17,4), número de consultas durante o pré-natal menor que seis (OR=4,4; IC=2,5-7,5), síndromes hemorrágicas (OR=2,9; IC=1,4-5,7), atendimento em outra unidade hospitalar nas 24 horas que antecederam a admissão da paciente na instituição (OR=2,9; IC=1,8-4,6), idade materna maior ou igual que 35 anos (OR=2,2; IC=1,0-4,9) e escolaridade menor que oito anos de estudo (OR=1,6; IC=1,02-2,6). CONCLUSÕES: foi encontrado um elevado coeficiente de mortalidade fetal, sendo os principais fatores associados aos óbitos: malformações, o número de consultas de pré-natal menor que seis, as síndromes hemorrágicas, história de atendimento anterior à admissão, idade materna ou igual que 35 anos e escolaridade menor que oito anos de estudo.Abstract PURPOSE: to investigate the main factors associated with fetal death in the city of Recife, Pernambuco, Brazil. METHODS: an observational, case-control study, including cases attended from June 1 st 2004 to 31 st March 2005. A number of 116 stillbirth cases and 472 live birth controls, with deliveries assisted at the service, were included. The cases were identified in the record book from the delivery room. The puerperium women were identified by the name and register number at a puerperium infirmary. The controls were selected, using the puerperium infirmary neighborhood criterion, identifying the beds with numbers immediately lower (two patients) and higher (two patients) than the patient's, as far as they had delivered live babies. In case they did not agree to participate in the research, the next beds with numbers consecutively lower or higher were approached. The χ 2 association and Fisher's exact tests were used when necessary to test the association between the independent (predictive) and dependent (stillborn) variables, considering 5% as

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Section: Discussionunclassified

Fatores associados à natimortalidade em uma maternidade escola em Pernambuco: estudo caso-controle

Andrade¹,

Amorim²,

Cunha³

et al. 2009

Rev. Bras. Ginecol. Obstet.

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“…Maternal factors include older and younger maternal age; short pregnancy interval, maternal infections (syphilis, malaria in pregnancy), maternal obesity and malnutrition, cigarette smoking, alcohol and drug abuse, maternal disease (pre-eclampsia and eclampsia), previous stillbirth, primiparity and multiparity; fetal factors include male sex, prematurity, extremes of birth weight; while contextual factors include lack of Access to Antenatal Care (ANC), lack of skilled care during child birth, rural residence, low socioeconomic status, type of marriage, ethnicity, poor maternal education and environmental pollution particularly indoor air pollution [1] [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Stillbirth in Nigeria: Rates and Risk Factors Based on 2013 Nigeria DHS

Dahiru¹,

Aliyu²

2016

OALib

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Introduction: Stillbirth remains a public health problem with an estimate of 2.6 million stillbirths in 2015 of which 98% occurred in low-and middle-income countries and over three-quarters of these occurring in Sub-Saharan Africa (SSA) and south Asia. Further, only ten countries carry the burden of over 65% of total stillbirths in the world including Nigeria in the second position. The objective of this analysis is to estimate stillbirth rates and identify the determinants of stillbirth in Nigeria using the 2013 Nigeria DHS data. Methods: The study utilized the nationally-representative sample of women of reproductive age interviewed during the 2013 Nigeria DHS. Analysis was restricted to 31,671 women aged 15 -49 years who had a pregnancy reaching at least seven months of gestation in the five-year period prior to the survey. Descriptive statistics and regression analysis were performed using Stata v13 to determine significant factors related to stillbirth. Incidence Risk Ratio (IRR) was used to assess strength of association between independent and dependent variables. Results: Overall stillbirth rate is 12.5 per 1000 pregnancies, with rates as high as 22 per 1000 (among women aged 15 -19 years) and as low as 6.4 per 1000 (among women who received skilled ANC). Age, household wealth, higher birth order, facility delivery, Caesarean delivery, rural residence and ever use of contraceptive are consistent determinants of stillbirth in both the bivariate and multivariate models. Women in rich households have lower IRR of stillbirth (0.60; 95% CI: 0.45 -0.59) as well as women who had ever used modern contraception (IRR = 0.72; 95% CI: 0.63 -0.81). However, health facility deliveries as well as deliveries through a C-section, rural residence and age older than 20 years all carry increased risk of stillbirth (IRR = 1.81; 95% CI: 1.05 -1.33), (IRR = 2.46; 95% CI: 2.03 -2.98), (IRR = 1.41; 95% CI: 1.24 -1.59), and (IRR = 2.23; 95% CI: 1.75 -2.59) respectively. Conclusions: The study revealed that there are several factors responsible for stillbirth in Nigeria. Age, household wealth, higher birth order, facility delivery, Caesarean delivery, rural residence and ever use of contraceptive are consistent determinants of stillbirth in both the bivariate and multivariate models. There is urgent need by the National government to improve quality of maternal health care services and interventions to improve utilization and quality of prenatal care.

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“…It is thought that globally there are at least 3.2 million stillbirths per year [10]. Infections, problems related to the placenta and umbilical cord, congenital anomalies, maternal [11]. A number of investigations, including autopsy, examination of the placenta, amniocentesis and tests on blood from the mother and child, have been recommended in the diagnostic evaluation of IUFD [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

Drews¹,

Różycka²,

Barlik³

et al. 2017

Ginekol Pol

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Objectives: Choline and folate metabolism disturbances may be involved in the occurrence of intrauterine fetal death (IUFD). The proper activity of this metabolism could be determined by genetic variants involved in choline pathway e.g. CHKA (gene encoding choline kinase α), PCYT1A (gene encoding CCTα) and CHDH (gene encoding choline dehydrogenase). Our study aimed at determining the genotype and allele frequencies of CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms in mothers with IUFD occurrence. Material and methods:The study involved 76 mothers with IUFD occurrence and 215 mothers of healthy children. Genetic analysis was performed with the use of PCR/RFLP method. Results:The frequency of genotypes and alleles of studied polymorphisms was similar in both groups. The study revealed no association of PCYT1A, CHKA and CHDH polymorphisms in analysed groups of women. While evaluating the co-existence of analysed polymorphisms statistically significant correlation was revealed. Co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes was observed statistically more frequently in the study group than in the control group (p = 0,031). Conclusions:There is no correlation between single CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms and the incidence of intrauterine fetal death. However, revealed statistically significant difference between co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes between study groups suggest the need of further analysis.

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Risk Factors for Stillbirth in Developing Countries: A Systematic Review of the Literature

Cited by 120 publications

References 37 publications

Fatores associados à natimortalidade em uma maternidade escola em Pernambuco: estudo caso-controle

Fatores associados à natimortalidade em uma maternidade escola em Pernambuco: estudo caso-controle

Stillbirth in Nigeria: Rates and Risk Factors Based on 2013 Nigeria DHS

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

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