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Maternal health care program and markers for late fetal death

Walles, Bengt; Tyden, Tommy; Herbst, Andreas LU ; Ljungblad, Ulf and Rydhstrom, Håkan (1994) In Acta Obstetricia et Gynecologica Scandinavica 73(10). p.773-778
Abstract
OBJECTIVE. To identify markers for late fetal death, a multicenter study was performed, based on routinely obtained data from maternal health care units. MATERIAL AND METHODS. Prospectively recorded data were obtained from maternal health care units belonging to five delivery units. In all, 233 consecutive cases of singleton pregnancy involving late fetal death (> or = 28 weeks) were identified between 1983 and 1989. As a control for each case, the next consecutive mother giving birth to a live infant at the same delivery unit was selected, the sole matching criterium being parity. RESULTS. After exclusion of pregnancies with lethal malformations or trauma, 205 cases remained for the statistical analysis. Two main subgroups were... (More)
OBJECTIVE. To identify markers for late fetal death, a multicenter study was performed, based on routinely obtained data from maternal health care units. MATERIAL AND METHODS. Prospectively recorded data were obtained from maternal health care units belonging to five delivery units. In all, 233 consecutive cases of singleton pregnancy involving late fetal death (> or = 28 weeks) were identified between 1983 and 1989. As a control for each case, the next consecutive mother giving birth to a live infant at the same delivery unit was selected, the sole matching criterium being parity. RESULTS. After exclusion of pregnancies with lethal malformations or trauma, 205 cases remained for the statistical analysis. Two main subgroups were identified: mothers with placental abruption (n = 44), and pregnancies with no obvious reason for fetal death (n = 101). An increased risk for late fetal death was evident in expectant mothers > or = 40 years (10 vs 1; chi 2 = 7.6, p < 0.01), and in smokers where an association was seen to placental abruption. A significantly increased risk was also seen in women with medical treatment for essential hypertension (8 vs 1; chi 2 = 5.6, p < 0.05). On the other hand, we found no correlation between proteinuria, glucosuria, decreasing symphysis-fundal height, or changes in the Hb, on the one hand, and late fetal demise, on the other. There was no overrepresentation of post dated pregnancy (by ultrasound early in the second trimester) among the cases. Nor did post dated pregnancies (> or = 42 weeks) estimated from first day of last menstrual period (but not post dated by ultrasound) imply a higher rate of fetal death, as has been suggested in previous studies. CONCLUSION. In the present material, there was no sign of systematic error in the evaluation of data routinely obtained from the antenatal clinics and maternity units. Apart from placental abruption in smokers, a high maternal age, and medical treatment for essential hypertension, deviating data were recorded as often among controls as among cases. No correlation was evident between a post date pregnancy and fetal demise. A short symphysis-fundal height was recorded as often among controls as among cases and the even distribution of fetal birthweight in case pregnancies around the standard curve for the normal population is noteworthy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antenatal care, maternal age, placental abruption, smoking, stillbirth, ultrasound
in
Acta Obstetricia et Gynecologica Scandinavica
volume
73
issue
10
pages
773 - 778
publisher
Wiley-Blackwell
external identifiers
  • pmid:7817727
  • scopus:0028574847
ISSN
1600-0412
DOI
10.3109/00016349409072503
language
English
LU publication?
yes
id
8cb815a2-1cd9-43aa-a41b-28c9fcea0153 (old id 1107853)
date added to LUP
2008-07-22 16:18:26
date last changed
2017-01-01 07:10:10
@article{8cb815a2-1cd9-43aa-a41b-28c9fcea0153,
  abstract     = {OBJECTIVE. To identify markers for late fetal death, a multicenter study was performed, based on routinely obtained data from maternal health care units. MATERIAL AND METHODS. Prospectively recorded data were obtained from maternal health care units belonging to five delivery units. In all, 233 consecutive cases of singleton pregnancy involving late fetal death (&gt; or = 28 weeks) were identified between 1983 and 1989. As a control for each case, the next consecutive mother giving birth to a live infant at the same delivery unit was selected, the sole matching criterium being parity. RESULTS. After exclusion of pregnancies with lethal malformations or trauma, 205 cases remained for the statistical analysis. Two main subgroups were identified: mothers with placental abruption (n = 44), and pregnancies with no obvious reason for fetal death (n = 101). An increased risk for late fetal death was evident in expectant mothers &gt; or = 40 years (10 vs 1; chi 2 = 7.6, p &lt; 0.01), and in smokers where an association was seen to placental abruption. A significantly increased risk was also seen in women with medical treatment for essential hypertension (8 vs 1; chi 2 = 5.6, p &lt; 0.05). On the other hand, we found no correlation between proteinuria, glucosuria, decreasing symphysis-fundal height, or changes in the Hb, on the one hand, and late fetal demise, on the other. There was no overrepresentation of post dated pregnancy (by ultrasound early in the second trimester) among the cases. Nor did post dated pregnancies (&gt; or = 42 weeks) estimated from first day of last menstrual period (but not post dated by ultrasound) imply a higher rate of fetal death, as has been suggested in previous studies. CONCLUSION. In the present material, there was no sign of systematic error in the evaluation of data routinely obtained from the antenatal clinics and maternity units. Apart from placental abruption in smokers, a high maternal age, and medical treatment for essential hypertension, deviating data were recorded as often among controls as among cases. No correlation was evident between a post date pregnancy and fetal demise. A short symphysis-fundal height was recorded as often among controls as among cases and the even distribution of fetal birthweight in case pregnancies around the standard curve for the normal population is noteworthy.},
  author       = {Walles, Bengt and Tyden, Tommy and Herbst, Andreas and Ljungblad, Ulf and Rydhstrom, Håkan},
  issn         = {1600-0412},
  keyword      = {antenatal care,maternal age,placental abruption,smoking,stillbirth,ultrasound},
  language     = {eng},
  number       = {10},
  pages        = {773--778},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Maternal health care program and markers for late fetal death},
  url          = {http://dx.doi.org/10.3109/00016349409072503},
  volume       = {73},
  year         = {1994},
}