{"title":"小胎龄分娩和围产期死亡率的孕前危险因素。","authors":"C V Isaksen, R N Laurini, G Jacobsen","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>The Scandinavian part of the NICHD study of successive small-for-gestational-age (SGA) births included 5722 parous women from Trondheim and Bergen (in Norway) and Uppsala (in Sweden). Study enrollment took place from January 1986 through March 1988. The aim of the main study was to investigate factors associated with inhibited intrauterine growth. This paper reports on the fetal, perinatal, and neonatal deaths among the births in the study in relation to different risk factors. The cause of deaths were analyzed to see if there were any associations with the risk factors. There was a total of 84 deaths, 65 of these were fetal, perinatal or neonatal deaths and included in this analysis. The remaining 19 are for different reasons excluded. Thirty-two (60%) of the autopsies regarded the high risk group who comprised only 42.4% of the total study population. The high risk group was selected using the following risk criteria: a previous low weight birth or perinatal death, maternal low weight (pre-pregnancy weight < 50 kg), the presence of a chronic maternal disease, and smoking at the time of conception. A significant association was found between perinatal mortality and the presence of one or more of the defined risk criteria (relative risk 2.0; 95% CI 1.2, 3.4). Asphyxia and related disorders was the most important single cause of death and was found to be associated with the maternal risk factors (RR 3.9; 95% CI 1.5, 9.8). A significant association was found between maternal risk factors and SGA autopsies (RR 3.9; 95% CI 1.7, 8.9). No association was found between asphyxia and SGA. It is concluded that women with risk factors based on complications in a previous pregnancy are more prone to stillbirths, perinatal, and neonatal deaths, and with asphyxia as the most prominent cause of death.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"165 ","pages":"44-9"},"PeriodicalIF":0.0000,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pre-pregnancy risk factors of small-for-gestational-age births and perinatal mortality.\",\"authors\":\"C V Isaksen, R N Laurini, G Jacobsen\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The Scandinavian part of the NICHD study of successive small-for-gestational-age (SGA) births included 5722 parous women from Trondheim and Bergen (in Norway) and Uppsala (in Sweden). Study enrollment took place from January 1986 through March 1988. The aim of the main study was to investigate factors associated with inhibited intrauterine growth. This paper reports on the fetal, perinatal, and neonatal deaths among the births in the study in relation to different risk factors. The cause of deaths were analyzed to see if there were any associations with the risk factors. There was a total of 84 deaths, 65 of these were fetal, perinatal or neonatal deaths and included in this analysis. The remaining 19 are for different reasons excluded. Thirty-two (60%) of the autopsies regarded the high risk group who comprised only 42.4% of the total study population. The high risk group was selected using the following risk criteria: a previous low weight birth or perinatal death, maternal low weight (pre-pregnancy weight < 50 kg), the presence of a chronic maternal disease, and smoking at the time of conception. A significant association was found between perinatal mortality and the presence of one or more of the defined risk criteria (relative risk 2.0; 95% CI 1.2, 3.4). Asphyxia and related disorders was the most important single cause of death and was found to be associated with the maternal risk factors (RR 3.9; 95% CI 1.5, 9.8). A significant association was found between maternal risk factors and SGA autopsies (RR 3.9; 95% CI 1.7, 8.9). No association was found between asphyxia and SGA. It is concluded that women with risk factors based on complications in a previous pregnancy are more prone to stillbirths, perinatal, and neonatal deaths, and with asphyxia as the most prominent cause of death.</p>\",\"PeriodicalId\":75400,\"journal\":{\"name\":\"Acta obstetricia et gynecologica Scandinavica. 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引用次数: 0
摘要
NICHD研究的斯堪的纳维亚部分包括来自特隆赫姆和卑尔根(挪威)和乌普萨拉(瑞典)的5722名分娩妇女。研究登记时间从1986年1月到1988年3月。主要研究的目的是调查与抑制宫内生长有关的因素。本文报道了研究中新生儿中胎儿、围产期和新生儿死亡与不同危险因素的关系。研究人员对死亡原因进行了分析,以确定是否与风险因素有任何关联。总共有84例死亡,其中65例是胎儿、围产期或新生儿死亡,并纳入了这一分析。其余19人因不同原因被排除在外。32例(60%)尸检属于高危人群,仅占总研究人群的42.4%。根据以下风险标准选择高风险组:以前出生体重过低或围产期死亡、产妇体重过低(孕前体重< 50公斤)、产妇患有慢性疾病以及怀孕时吸烟。围产期死亡率与存在一个或多个确定的危险标准之间存在显著关联(相对危险度2.0;95% ci 1.2, 3.4)。窒息及相关疾病是最重要的单一死亡原因,并被发现与孕产妇危险因素相关(RR 3.9;95% ci 1.5, 9.8)。产妇危险因素与SGA尸检之间存在显著关联(RR 3.9;95% ci 1.7, 8.9)。没有发现窒息和SGA之间的关联。结论是,具有基于先前妊娠并发症的危险因素的妇女更容易发生死产、围产期和新生儿死亡,而窒息是最主要的死亡原因。
Pre-pregnancy risk factors of small-for-gestational-age births and perinatal mortality.
The Scandinavian part of the NICHD study of successive small-for-gestational-age (SGA) births included 5722 parous women from Trondheim and Bergen (in Norway) and Uppsala (in Sweden). Study enrollment took place from January 1986 through March 1988. The aim of the main study was to investigate factors associated with inhibited intrauterine growth. This paper reports on the fetal, perinatal, and neonatal deaths among the births in the study in relation to different risk factors. The cause of deaths were analyzed to see if there were any associations with the risk factors. There was a total of 84 deaths, 65 of these were fetal, perinatal or neonatal deaths and included in this analysis. The remaining 19 are for different reasons excluded. Thirty-two (60%) of the autopsies regarded the high risk group who comprised only 42.4% of the total study population. The high risk group was selected using the following risk criteria: a previous low weight birth or perinatal death, maternal low weight (pre-pregnancy weight < 50 kg), the presence of a chronic maternal disease, and smoking at the time of conception. A significant association was found between perinatal mortality and the presence of one or more of the defined risk criteria (relative risk 2.0; 95% CI 1.2, 3.4). Asphyxia and related disorders was the most important single cause of death and was found to be associated with the maternal risk factors (RR 3.9; 95% CI 1.5, 9.8). A significant association was found between maternal risk factors and SGA autopsies (RR 3.9; 95% CI 1.7, 8.9). No association was found between asphyxia and SGA. It is concluded that women with risk factors based on complications in a previous pregnancy are more prone to stillbirths, perinatal, and neonatal deaths, and with asphyxia as the most prominent cause of death.