title: Recurrence of adverse perinatal outcomes in developing countries.
abstract: OBJECTIVE
  To evaluate the risk of recurrence of adverse perinatal outcomes in second pregnancies in developing countries.
  
  
  METHODS
  Data from the 2004-2008 Global Survey on Maternal and Perinatal Health were used to determine the outcomes of singleton second pregnancies for 61 780 women in 23 developing countries. The mother-infant pairs had been followed up until discharge or for 7 days postpartum.
  
  
  RESULTS
  At the end of their second pregnancies, women whose first pregnancy had ended in stillbirth (n = 1261) or been followed by neonatal death (n = 1052) were more likely than women who had not experienced either outcome to have given birth to a child with a birth weight of < 1500 g (odds ratio, OR: 2.52 and 2.78, respectively) or 1500-2499 g (OR: 1.22 and 1.60, respectively), or to an infant requiring admission to an intensive care unit (OR: 1.64 and 1.68, respectively). At the end of their second pregnancies, those whose first pregnancy had ended in a stillbirth were at increased risk of another stillbirth (OR: 2.35) and those whose first infant had died as a neonate were at increased risk of having the second infant die within the first 7 days of life (OR: 2.82). These trends were found to be largely unaffected by the continent in which the women lived.
  
  
  CONCLUSIONS
  In the developing world, a woman whose first pregnancy ends in stillbirth or is followed by the death of the neonate is at increased risk of experiencing the same outcomes in her second pregnancy.
authors.affiliation: MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and School of Public Health, Shanghai, 200092, China.
authors.forename: Fengxiu
authors.initials: F
authors.lastname: Ouyang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Ana Pilar
authors.initials: AP
authors.lastname: Betrán
authors.forename: Zujing
authors.initials: Z
authors.lastname: Yang
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Souza
authors.forename: Mario
authors.initials: M
authors.lastname: Merialdi
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D007230:Infant, Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology