Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

• Autor(a) principal: Almeida,Marcia Furquim de
• Data de Publicação: 2007
• Outros Autores: Alencar,Gizelton Pereira, Novaes,Hillegonda Maria Dutilh, França Jr,Ivan, Siqueira,Arnaldo Augusto Franco de, Campbell,Oona M R, Schoeps,Daniela, Rodrigues,Laura Cunha
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista de Saúde Pública
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102007000100006
• topic: Antepartum fetal death; Prenatal care; Risk factors; Socioeconomic factors; Case-control study; Pregnancy

OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.