Risk factors for antepartum fetal death.
OBJECTIVE
To determine the demographic, maternal, pregnancy-related and fetal risk factors for antepartum fetal death (APFD).


METHODS
From our perinatal database between the years 1990 and 1997, 68,870 singleton birth files were analyzed. Fetuses weighing < 1,000 g at birth and those with structural malformations and/or known chromosomal anomalies were excluded from the study. In order to determine independent factors contributing to APFD, a multiple logistic regression model was constructed.


RESULTS
During the study period there were 246 cases of APFD (3.6 per 1,000 births). The following obstetric factors significantly correlated with APFD in a multiple logistic regression model: preterm deliveries: small size for gestational age (SGA), multiparity (> 5 deliveries), oligohydramnios, placental abruption, umbilical cord complications (cord around the neck and true knot of cord), pathologic presentations (nonvertex) and meconium-stained amniotic fluid. APFD was not significantly associated with advanced maternal age.


CONCLUSIONS
APFD was significantly associated with several risk factors. Placental and umbilical cord pathologies might be the direct cause of death. Grand multiparity, oligohydramnios, meconium-stained amniotic fluid, pathologic presentations and suspected SGA should be carefully evaluated during pregnancy in order to decrease the incidence of APFD.
Oron
T
T
Departments of Obstetrics and Gynecology and of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sheiner
E
E
Shoham-Vardi
I
I
Mazor
M
M
Katz
M
M
Hallak
M
M
D000328:Adult; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D012307:Risk Factors