Influence of Birthweight on the Prospective Stillbirth Risk in the Third Trimester: A Cross-Sectional Cohort Study

Stephen Contag; Clayton Brown; Sarah Crimmins; Katherine Goetzinger

doi:10.1055/s-0036-1587322

American Journal of Perinatology Reports, Inhaltsverzeichnis

AJP Rep 2016; 06(03): e287-e298
DOI: 10.1055/s-0036-1587322

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influence of Birthweight on the Prospective Stillbirth Risk in the Third Trimester: A Cross-Sectional Cohort Study

Autor*innen

Stephen Contag

¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
Clayton Brown

²Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
Sarah Crimmins

¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
Katherine Goetzinger

¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland

Abstract

Objective The objective of this study was to determine the effect of birthweight on prospective stillbirth risk.

Methods Cross-sectional study of singleton births in the United States from 2010 to 2012 from 32 through 42 weeks was conducted. Stillbirth risk was stratified by birthweight and gestational age adjusted for time from death to delivery. The primary outcome was the prospective stillbirth risk for each birthweight category. Student t-test was used for continuous data, chi-square to compare categorical data. Binomial proportions were used to derive prospective and cumulative risks. Cox proportional hazards regression with log–rank test comparison for heterogeneity was used to compare birthweight categories and derive hazard ratios.

Results There was an increase in the risk for stillbirth as birthweight diverged from the reference group. At 40 weeks adjusted gestational age, stillbirth rate per 10,000 births for the bottom (6.17, 95% CI: 7.47–4.87) and top (2.37, 95%CI: 3.1–1.65) 5th centiles of birthweight conveyed the highest risk. Hazard ratios (HR) after adjusting for covariates were: 1.55 (1.73–1.4) <5th centile and 2.2 (2.43–1.99) > 95th centile (p < 0.001).

Conclusion Stillbirth risk increases as birthweight departs from the mean. Birthweight below the 5th and above the 95th centile conveyed a significantly increased risk for stillbirth which was most noticeable after 37 weeks.

Keywords

third trimester - birthweight - stillbirth - growth restriction - prospective risk

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Referenzen

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