Factors associated with nonanomalous stillbirths: The Utah Stillbirth Database 1992-2002

This study was undertaken to characterize risk factors associated with nonanomalous stillborn (SB) infants and to ascribe the probability of fetal survival by gestational age among high-risk pregnancies. We compiled a database of all SB infants and an equivalent number of controls using information...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2006-03, Vol.194 (3), p.849-854
Main Authors: Aagaard-Tillery, Kjersti M., Holmgren, Calla, Lacoursiere, D. Yvette, Houssain, Shaheen, Bloebaum, Lois, Satterfield, Robert, Branch, D. Ware, Varner, Michael W.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Databases, Factual
Diseases of mother, fetus and pregnancy
Female
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Hypertension in pregnancy
Intrauterine fetal death
Medical sciences
Perinatal database
Pregnancy
Pregnancy complications
Pregnancy Complications - epidemiology
Pregnancy. Fetus. Placenta
Risk Factors
Stillbirth
Stillbirth - epidemiology
Survival Rate
Utah
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Summary:This study was undertaken to characterize risk factors associated with nonanomalous stillborn (SB) infants and to ascribe the probability of fetal survival by gestational age among high-risk pregnancies. We compiled a database of all SB infants and an equivalent number of controls using information obtained from Utah Birth and Fetal Death Certificates during the years 1992 through 2002. Adjusted and unadjusted odds ratios for risk factors associated with SB were generated. Cox proportional hazard models were used to generate survival curves comparing pregnancies complicated by chronic hypertension or gestational hypertension with those of controls. Infants with major anomalies were eliminated from both cases and controls, to generate 1566 nonanomalous SBs and 2720 nonanomalous controls. In a logistic regression model controlling for multiple maternal and fetal factors, placental abruption, hydramnios, cord prolapse, and essential hypertension were associated with an increased risk of SB. In pregnancies complicated by essential hypertension, the survival curve diverged from that of controls at those gestational ages approaching term (hazard ratio 2.24; 95% CI 1.52-3.32). SB in nonanomalous infants in Utah is more common among pregnancies complicated by placental abruption, hydramnios, cord prolapse, and essential hypertension.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2005.09.017