International Journal of Epidemiology 2002;31:661-668
© International Epidemiological Association 2002
Perinatal Epidemiology |
Can clinical risk factors for late stillbirth in West Africa be detected during antenatal care or only during labour?
a Institut National de la Santé et de la Recherche Médicale. Unité 149 Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes, Paris, France.
b Burkina Faso: Ouedraogo C, Sondo B, Testa J, Koné B; Ivory Coast: Barbé T, Berche T, Bohoussou MK, Eono P, Koffi AS, Ortiz P, Portal JL, Tano-Bian A, Touré-Coulibally K, Welffens-Ekra C, Zadi F; Mali: Decam C, Doucouré-Diallo A, Duponchel JL, Huguet D, Prual A; Mauritania: Cunin P, Ould El Joud D; Niger: Alfari D, Mounkaila N, Vangeenderhuysen C; Senegal: de Bernis L, Bouillin D, Dompnier JP, Gueye A; Ministère de la Coopération, France: Laure JM, Leloup M.
Marie-Hélène Bouvier-Colle, INSERM U149, 123 Boulevard de Port-Royal, 75014 Paris, France. E-mail: bouvier-colle{at}cochin.inserm.fr
Background Recent studies have shown that the most important risk factors for perinatal mortality in developing countries are not detectable during antenatal care but can be observed only shortly before or during labour. Although 60% of perinatal deaths in these countries are stillbirths, few epidemiological studies focus on them. We tested the hypothesis that the risk factors for late stillbirth in West Africa are detectable principally shortly before or during labour.
Methods Data came from a prospective population-based study (the MOMA survey) that collected information about 20 326 pregnant women in seven areas, primarily urban, in West Africa.
Results There were 19 870 singleton births. The stillbirth rate was 25.9 per 1000 total births (95% CI: 23.7–28.1). In the crude analysis, after adjustment and consideration of prevalence, the principal risk factors for late stillbirth were: late antenatal or intrapartum vaginal bleeding, intrapartum hypertension, dystocia, and infection. Other risk factors were: maternal height (<150 cm), maternal age (>35 years), previous stillbirths, hypertension at the 8-month antenatal visit and number of antenatal visits (<2).
Conclusions The principal risk factors for late stillbirth observed in our study could be detected only in the late antenatal and intrapartum period. These results highlight the potential benefits of partograph use. They need to be confirmed by studies incorporating continuous intrapartum fetal monitoring.
Keywords Developing countries, West Africa, fetal death, epidemiology, multivariate analysis
Accepted 17 December 2001
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. S. Gibbs and D. J. Roberts Case 27-2007 -- A 30-Year-Old Pregnant Woman with Intrauterine Fetal Death N. Engl. J. Med., August 30, 2007; 357(9): 918 - 925. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Villamor, M. L. Dreyfuss, A. Baylin, G. Msamanga, and W. W. Fawzi Weight Loss During Pregnancy Is Associated with Adverse Pregnancy Outcomes among HIV-1 Infected Women J. Nutr., June 1, 2004; 134(6): 1424 - 1431. [Abstract] [Full Text] [PDF]
|
|