[Risk factors for fetal mortality in a public maternity hospital in Rio de Janeiro, Brazil: a case-control study].
Stillbirth rate is high in Brazil, and it is important to identify its determinants. A nested case-control was conducted to explore the determinants of fetal death in a population treated at public services in Rio de Janeiro from 2002 to 2004. Data were collected from mothers' interviews and medical records. A structured model was proposed to perform statistical analysis, attributing hierarchical levels: socioeconomic factors (distal level), reproductive, behavioral, and healthcare determinants (intermediate level), and fetal biological characteristics (proximal level). According to the findings, work stability, stable marital status, presence of a companion during admission, and adequate prenatal care had a protective effect against fetal death, while domestic violence, maternal morbidity, and intrauterine growth restriction increased the risk. Quality of prenatal care showed a large protective effect, thus becoming a key strategy for reducing fetal mortality in populations with low socioeconomic status.
Fonseca
Sandra Costa
SC
Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Niterói, Brasil. sandracfonseca@yahoo.com.br
Coutinho
Evandro Silva Freire
ES
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D046689:Fetal Mortality; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult