Stillbirth and Live Birth at Periviable Gestational Age: A Comparison of Prevalence and Risk Factors

Suzan L. Carmichael; Yair J. Blumenfeld; Jonathan A. Mayo; Jochen Profit; Gary M. Shaw; Susan R. Hintz; David K. Stevenson

doi:10.1055/s-0038-1670633

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2019; 36(05): 537-544
DOI: 10.1055/s-0038-1670633

Original Article

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

Stillbirth and Live Birth at Periviable Gestational Age: A Comparison of Prevalence and Risk Factors

Suzan L. Carmichael

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

,

Yair J. Blumenfeld

²Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California

,

Jonathan A. Mayo

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

,

Jochen Profit

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

,

Gary M. Shaw

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

,

Susan R. Hintz

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

,

David K. Stevenson

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

› Institutsangaben

Abstract

Objective We compared the prevalence of and risk factors for stillbirth and live birth at periviable gestational age (20–25 weeks).

Study Design This is a cohort study of 2.5 million singleton births in California from 2007 to 2011. We estimated racial–ethnic prevalence ratios and used multivariable logistic regression for risk factor comparisons.

Results In this study, 42% of deliveries at 20 to 25 weeks' gestation were stillbirths, and 22% were live births who died within 24 hours. The prevalence of delivery at periviable gestation was 3.4 per 1,000 deliveries among whites, 10.9 for blacks, 3.5 for Asians, and 4.4 for Hispanics. Nonwhite race–ethnicity, lower education, uninsured status, being U.S. born, older age, obesity, smoking, pre-pregnancy hypertension, nulliparity, interpregnancy interval, and prior preterm birth or stillbirth were all associated with increased risk of both stillbirth and live birth at 20 to 25 weeks' gestation, compared with delivery of a live birth at 37 to 41 weeks.

Conclusion Inclusion of stillbirths and live births in studies of deliveries at periviable gestations is important.

Keywords

stillbirth - periviable gestation - risk factor - race–ethnicity - preterm delivery

Volltext

Referenzen

References
1 Raju TN, Mercer BM, Burchfield DJ, Joseph GF. Periviable birth: executive summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists. J Perinatol 2014; 34 (05) 333-342
2 Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES. Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ 2012; 345: e7976
3 Fellman V, Hellström-Westas L, Norman M. , et al; EXPRESS Group. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA 2009; 301 (21) 2225-2233
4 Ray JG, Urquia ML. Risk of stillbirth at extremes of birth weight between 20 to 41 weeks gestation. J Perinatol 2012; 32 (11) 829-836
5 Deb-Rinker P, León JA, Gilbert NL. , et al; Canadian Perinatal Surveillance System Public Health Agency of Canada. Differences in perinatal and infant mortality in high-income countries: artifacts of birth registration or evidence of true differences?. BMC Pediatr 2015; 15: 112
6 Profit J, Woodard LD. Perils and opportunities of comparative performance measurement. Arch Pediatr Adolesc Med 2012; 166 (02) 191-194
7 Fretts R. Stillbirth epidemiology, risk factors, and opportunities for stillbirth prevention. Clin Obstet Gynecol 2010; 53 (03) 588-596
8 MacDorman MF, Gregory EC. Fetal and perinatal mortality: United States, 2013. Natl Vital Stat Rep 2015; 64 (08) 1-24
9 Carmichael SL, Blumenfeld YJ, Mayo J. , et al; March of Dimes Prematurity Research Center at Stanford University School of Medicine. Prepregnancy obesity and risks of stillbirth. PLoS One 2015; 10 (10) e0138549
10 Carmichael SL, Cullen MR, Mayo JA. , et al. Population-level correlates of preterm delivery among black and white women in the U.S. PLoS One 2014; 9 (04) e94153
11 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87 (02) 163-168
12 National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res 1998; 6 (Suppl. 02) 51S-209S
13 Ecker JL, Kaimal A, Mercer BM. , et al; American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine. #3: periviable birth. Am J Obstet Gynecol 2015; 213 (05) 604-614
14 DeFranco EA, Hall ES, Muglia LJ. Racial disparity in previable birth. Am J Obstet Gynecol 2016; 214 (03) 394.e1-394.e7
15 Spong CY, Iams J, Goldenberg R, Hauck FR, Willinger M. Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality. Obstet Gynecol 2011; 117 (04) 948-955
16 Goldenberg RL, McClure EM, Bhutta ZA. , et al; Lancet's Stillbirths Series steering committee. Stillbirths: the vision for 2020. Lancet 2011; 377 (9779): 1798-1805
17 Wingate MS, Smith RA, Petrini JR, Barfield WD. Disparities in gestational age-specific fetal mortality rates in the United States, 2009-2013. Ann Epidemiol 2017; 27 (09) 570-574
18 Rowland Hogue CJ, Silver RM. Racial and ethnic disparities in United States: stillbirth rates: trends, risk factors, and research needs. Semin Perinatol 2011; 35 (04) 221-233
19 Willinger M, Ko CW, Reddy UM. Racial disparities in stillbirth risk across gestation in the United States. Am J Obstet Gynecol 2009; 201 (05) 469.e1-469.e8
20 Rysavy MA, Li L, Bell EF. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Between-hospital variation in treatment and outcomes in extremely preterm infants. N Engl J Med 2015; 372 (19) 1801-1811
21 Lorch SA, Baiocchi M, Ahlberg CE, Small DS. The differential impact of delivery hospital on the outcomes of premature infants. Pediatrics 2012; 130 (02) 270-278
22 Stoll BJ, Hansen NI, Bell EF. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA 2015; 314 (10) 1039-1051
23 Pinar H, Goldenberg RL, Koch MA. , et al. Placental findings in singleton stillbirths. Obstet Gynecol 2014; 123 (2 Pt 1): 325-336
24 Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA 2011; 306 (22) 2459-2468

Zusatzmaterial

Supplementary Material