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