Life-table analysis of the risk of perinatal death at term and post term in singleton pregnancies.
OBJECTIVE
This study was undertaken to estimate the cumulative risk of perinatal death associated with delivery at each gestational week both at term and post term.


METHODS
The numbers of antepartum stillbirths, intrapartum stillbirths, neonatal deaths, and surviving neonates delivered at between 37 and 43 weeks' gestation in Scotland, 1985-1996, were obtained from national databases (n = 700,878) after exclusion of multiple pregnancies and deaths caused by congenital abnormality. The numbers of deaths at each gestational week were related to appropriate denominators: antepartum stillbirths were related to ongoing pregnancies, intrapartum stillbirths were related to all births (excluding antepartum stillbirths), and neonatal deaths were related to live births. The cumulative probability of perinatal death associated with delivery at each gestational week was estimated by means of life-table analysis.


RESULTS
The gestational week of delivery associated with the lowest cumulative risk of perinatal death was 38 weeks' gestation, whereas the perinatal mortality rate was lowest at 41 weeks' gestation. The risk of death increased more sharply among primigravid women after 38 weeks' gestation because of a greater risk of antepartum stillbirth. The relationships between risk of death and gestational age were similar for the periods 1985-1990 and 1991-1996.


CONCLUSIONS
Delivery at 38 weeks' gestation was associated with the lowest risk of perinatal death.
Laboratory for Pregnancy and Newborn Research, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
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Smith
D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D015993:Life Tables; D011247:Pregnancy; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland; D018709:Statistics, Nonparametric; D016019:Survival Analysis