title: Elevated risk for neonatal outcome following denial of pregnancy: results of a one-year prospective study compared with control groups.
abstract: OBJECTIVE
  Newborns following denied pregnancies are delivered after either late onset or total absence of antenatal care, with a presumed subsequently increased risk for neonatal outcome. For this specific group, several characteristic outcome parameters are investigated.
  
  
  METHODS
  During the period July 1, 1995 to June 30, 1996, a prospective case sampling was performed for denied pregnancies in Berlin. Besides determination of the parameters' frequency, comparison with two control groups is performed: a normal group (BBR, all Berlin deliveries in 1995) and a high risk group (VIR, all deliveries at a perinatal center in 1996).
  
  
  RESULTS
  Altogether 69 neonates occurred. For gestational age < 37 weeks, birth weight < 2500 g, small for gestational age, transferal rate of newborns to neonatal unit and surgical delivery, a statistically significant worse outcome is demonstrated for denied pregnancies versus BBR and VIR (p-level < 0.05). Neonatal mortality is 5.8% in all cases, the corrected rate is 1.5% (excluding three non-viable cases of 21st and 23rd week of gestation).
  
  
  CONCLUSIONS
  The data underline the elevated fetal outcome risk for newborns after denial of pregnancy. In this group, total absence or late onset of antenatal care results in a manifestation of pregnancy dependent risks. Preterm births and small for gestational age newborns, together with deaths, may be classified as at least potentially avoidable.
authors.affiliation: Department of Obstetrics, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wessel
authors.forename: Jan
authors.initials: J
authors.lastname: Endrikat
authors.forename: Ulrich
authors.initials: U
authors.lastname: Büscher
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D003717:Denial, Psychological; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn / Q000502:physiology*; D007236:Infant, Small for Gestational Age; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy / Q000523:psychology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000453:epidemiology