Stillbirth: risk factors. Support Hospital III - Sullana.

Abstract

OBJECTIVE. To determine the risk factors of intrauterine fetal death in a Northern Peruvian population. DESIGN: Retrospective, analytical, case control study of intrauterine fetal death in 2,743 deliveries with newborn weights 500 g or more and/or over 19 weeks gestation ATTENDED AT HOSPITAL DE APOYO III, SULLANA, PERÚ, BETWEEN JUNE 1994 AND JUNE 1995. Data were obtained by the CLAP Perinatal Informatic System. RESULTY: The 92 dead newborns gave a fetal death rate of 33,5 per 1000 newborns; 53,6% occurred during pregnancy, 30,4% in an unknown moment and 11,9% during delivery. Causes of intrauterine death were infections (44,6%), hemorrage (25%) and hipertension (9,8%). Cause of death was not determined in 16,3%. Risk factors of fetal death were: a) Maternal: multiparity (RR 1,65), induced delivery (RR 7,75), PNC (RR 0,44), breech (RR 2,95) and transverse PRESENTATION (RR 4,56), preterm delivery (RR 8,66) and maternal diseases (RR 3,14), mainly second trimester hemorrhage (RR 26,22), and b) Maternofetal and fetal: low birthweight (RR 11,30), preterm by physical examination (RR 10,42), cephalopelvic disproportion (RR 1,07) and malformations (RR 10,42). Risk factors that modified would decrease fetal death were: maternal pathology (RAP 0,51), low birthweigth (RAP 0,48), preterm by LMP (RAP 0,40), preterm by physical examination (RAP 0,40), malphormations (RAP 0,33), PNC (RAP 0,30), chronic anemia (RAP 0,20), TTH (RAP 0,14), induced delivery (RAP 0,11), breech presentation (RAP 0,10), older than 35 years (RAP 0,10), multiparity (RAP 0,07), threatened premature delivery (RAP 0,07), other infections (RAP 0,06), second trimester hemorrhage (RAP 0,05), transverse presentation (RAP 0,03) and previous by pertension (RAP 0,02).