Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

Martins, Marley Carvalho Feitosa; Feitosa, Francisco Edson de Lucena; Júnior, Antônio Brazil Viana; Correia, Luciano Lima; Ibiapina, Flávio Lúcio Pontes; Pacagnella, Rodolfo de Carvalho; Carvalho, Francisco Herlânio Costa

doi:10.1371/journal.pone.0216037

Cited by 8 publications

(12 citation statements)

References 20 publications

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“…During the study period, there were 28,580 deliveries , out of which 520 stillbirths occurred making the average stillbirth rate 18.19 per 1000 total births which was higher compared to a study by Dandona R et al in an Indian state where a SBR of 15.4/1000 births has been reported during 2017 [9] . However, SBR in our study was quite low compared to a study at a tertiary hospital in Brazil in 2017, where a SBR of 21.6 has been reported [10] . A downward trend in the SBR was observed, being 22.86%, 15.55% and 14.51% in the year 2016, 2017 and 2018 respectively (Table 1, Fig 1).…”

Section: Discussioncontrasting

confidence: 90%

“…It has been documented that women with no prenatal care had significant increased risk of stillbirths [15] and is a determinant factor associated with the occurrence of fetal deaths [10] . Similar results were revealed in our study that 54.81% of women were unbooked and had no or inadequate prenatal care (Table2).…”

Section: Discussionmentioning

confidence: 99%

“…We had 44 (8.46%) intrapartum stillbirths where fetal heart was present at admission (Table 5) which was less than the reported 10% incidence of intrapartum still births in developed countries [27] . Martin et al estimated 13.9% stillbirths in intrapartum period [10] . In India, 46.4% intrapartum stillbirths have been reported in Bihar state by Dandona R et al [9] .…”

Section: International Journal Of Innovative Research In Medical Science (Ijirms)mentioning

confidence: 99%

“…Individual attributes -birth order, previous birth intervals, mother's age at marriage, conception are also important [11] . Family-centered approaches and women supported by health care providers can encourage and improve both maternal health and reduction in fetal deaths [10] .…”

Section: Prevention Strategies At the Level Of Community And Familymentioning

confidence: 99%

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Stillbirths: Incidence, Causes and Surrogate Markers of Intrapartum and Antepartum Fetal Deaths

Shanker¹,

Saini

Gupta³

2020

ijirms

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Background: Stillbirth is a traumatic experience for both the patient and the obstetrician. Determining its cause and early interventions can reduce stillbirths. The study was undertaken to determine the incidence, evaluate causes and surrogate markers for intrapartum and antepartum stillbirths. Methods: A retrospective study was carried out from August 2015 to December 2018. All stillbirths more than 22 weeks or a birthweight of ≥500 g were included in the study. Demographic and all clinical details were collected from the indoor case records and cause of fetal death assigned. Results: There were 520 stillbirths and 28,580 deliveries in the study period. Majority of these women with stillbirths were in the age group of 20-25 years at 33-37 weeks period of gestation, had parity 1 to 3 and were unbooked. Intrapartum deaths accounted for only 8.46% stillbirths. Extreme prematurity was the most common cause for stillbirths (20.38%) followed by chorioamnionitis (16.73%), hypertensive diseases (15.77%) and abruption (10.38). The cause remained unknown in 53.27%. Fetal movement appeared a better surrogate of antepartum /intrapartum deaths than macerated/fresh stillborns. Conclusions: Incidence of stillbirths was 1.8%. Most of the deaths were antepartum (91.53%). Extreme prematurity was the commonest cause. Fetal movement appeared a better surrogate marker of intrapartum / antepartum deaths.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: International Journal Of Innovative Research In Medical Science (Ijirms)mentioning

confidence: 99%

Section: Prevention Strategies At the Level Of Community And Familymentioning

confidence: 99%

See 2 more Smart Citations

Stillbirths: Incidence, Causes and Surrogate Markers of Intrapartum and Antepartum Fetal Deaths

Shanker¹,

Saini

Gupta³

2020

ijirms

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“…Another study on the same subject that aimed to identify the association between delayed obstetric care and fetal death outcomes reported that the first, second, and third delays contributed to these outcomes [18], showing that delays in maternal care at any levels increase the chances of perinatal complications. We believe that neonatal morbimortality cannot be attributed to a single delay, but to a combination of factors that lead to an unfavorable outcome.…”

Section: Discussionmentioning

confidence: 99%

Delays in obstetric care increase the risk of neonatal near-miss morbidity events and death: a case-control study

Carvalho

Viana

Augusto

et al. 2020

BMC Pregnancy Childbirth

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Background: To evaluate the association between delays in obstetric care and neonatal near-miss mortality events and death in a public maternity referral center. Methods: This case-control study enrolled 142 neonates, meeting the near-miss criteria of 5-min Apgar < 7, weight < 1500 g, gestational age < 32 weeks, and use of mechanical ventilation or congenital malformation, as well as 284 controls (without the near-miss criteria), at a ratio of 1:2. After follow-up, the following outcomes were reclassified: survival of the neonatal period without the near-miss criteria (true "controls"), "near-miss," and "neonatal death." Maternal sociodemographic characteristics, prenatal care, and pregnancy resolution were evaluated. Pearson's chi-square and Fisher's exact tests were used. Simple logistic regression was performed to determine the association between the three delay factors with near-miss outcomes and/or neonatal death. The variables that had maintained values of p < 0.05 were subjected to multinomial logistic regression. Results: Comparisons revealed the following associations: for controls and near-miss events, delayed access to health services due to a lack of specialized services (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.8-5.1) and inappropriate conduct with the patient (OR, 12.1; 95% CI, 1.3-108.7); for controls and death, absent or inadequate prenatal care (OR, 3.3; 95% CI, 1.6-7.1) and delayed access to health services due to a lack of specialized services (OR, 2.5; 95% CI, 1.1-5.6); and for near-miss events and death, absent or inadequate prenatal care (OR, 2.2; 95% CI, 1.0-5.0). Logistic regression for the combined outcome (near-miss plus neonatal deaths) revealed absent or inadequate prenatal care (OR, 1.9; 95% CI, 1.2-2.8), lack of specialized services (OR, 2.8; 95% CI, 1.7-4.5), and improper conduct with the patient (OR, 10.6; 95% CI, 1.2-91.8). Conclusions: The delays in obstetric care associated with the presence of near-miss and/or neonatal death included absent or inadequate prenatal care, delayed access to health services due to a lack of specialized services, and inappropriate conduct with the patient.

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Investigation of stillbirths in Brazil: A systematic scoping review of the causes and related reporting processes in the past decade

Souza

Brasileiro

Ong

et al. 2022

Intl J Gynecology & Obste

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Background Recognizing the causes of stillbirths and their associated conditions is essential to reduce its occurrence. Objective To describe information on stillbirths in Brazil during the past decade. Search strategy A literature search was performed from January 2010 to December 2020. Selection criteria Original observational studies and clinical trials. Data collection and analysis Data were manually extracted to a spreadsheet and descriptive analysis was performed. Results A total of 55 studies were included; 40 studies (72.2%) used the official data stored by national public health systems. Most articles aimed to estimate the rate and trends of stillbirth (60%) or their causes (55.4%). Among the 16 articles addressing the causes of death, 10 (62.5%) used the International Classification of Diseases; most of the articles only specified the main cause of death. Intrauterine hypoxia was the main cause reported (ranging from 14.3% to 54.9%). Conclusion Having a national system based on compulsory notification of stillbirths may not be sufficient to provide quality information on occurrence and, especially, causes of death. Further improvements of the attribution and registration of causes of deaths and the implementation of educational actions for improving reporting systems are advisable. Finally, expanding the investigation of contributing factors associated with stillbirths would create an opportunity for further development of prevention strategies in low‐ and middle‐income countries such as Brazil.

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Pregnancies with an outcome of fetal death present higher risk of delays in obstetric care: A case-control study

Cited by 8 publications

References 20 publications

Stillbirths: Incidence, Causes and Surrogate Markers of Intrapartum and Antepartum Fetal Deaths

Stillbirths: Incidence, Causes and Surrogate Markers of Intrapartum and Antepartum Fetal Deaths

Delays in obstetric care increase the risk of neonatal near-miss morbidity events and death: a case-control study

Investigation of stillbirths in Brazil: A systematic scoping review of the causes and related reporting processes in the past decade

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