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

Authors

  • Marcia Furquim de Almeida Universidade de São Paulo; Faculdade de Saúde Pública; Departamento de Epidemiologia
  • Gizelton Pereira Alencar Universidade de São Paulo; Faculdade de Saúde Pública; Departamento de Epidemiologia
  • Hillegonda Maria Dutilh Novaes USP; Faculdade de Medicina; Departamento de Medicina Preventiva
  • Ivan França Jr USP; FSP; Departamento de Saúde Materno-Infantil
  • Arnaldo Augusto Franco de Siqueira USP; FSP; Departamento de Saúde Materno-Infantil
  • Oona M R Campbell London School of Hygiene and Tropical Medicine; Infectious Diseases Epidemiology Unit
  • Daniela Schoeps Universidade de São Paulo; Faculdade de Saúde Pública; Departamento de Epidemiologia
  • Laura Cunha Rodrigues London School of Hygiene and Tropical Medicine; Infectious Diseases Epidemiology Unit

DOI:

https://doi.org/10.1590/S0034-89102007000100006

Keywords:

Antepartum fetal death, Prenatal care, Risk factors, Socioeconomic factors, Case-control study, Pregnancy

Abstract

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.

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Published

2007-02-01

Issue

Section

Original Articles

How to Cite

Almeida, M. F. de, Alencar, G. P., Novaes, H. M. D., França Jr, I., Siqueira, A. A. F. de, Campbell, O. M. R., Schoeps, D., & Rodrigues, L. C. (2007). Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil . Revista De Saúde Pública, 41(1), 35-43. https://doi.org/10.1590/S0034-89102007000100006