Perinatal death: worse obstetric and neonatal outcome in a subsequent pregnancy

Recurrence risk of stillbirth in a second pregnancy

OBJECTIVE

To examine the risk of recurrence of stillbirth in a second pregnancy.

DESIGN

Retrospective cohort study.

SETTING

Scotland, UK.

POPULATION

All women who delivered their first and second pregnancies in Scotland between 1981 and 2005.

METHODS

All women delivering for the first time between 1981 and 2000 were linked to records of their second pregnancy using routinely collected data from the Scottish Morbidity Returns. Women who had an intrauterine death in their first pregnancy formed the exposed cohort, whereas those who had a live birth formed the unexposed cohort.

MAIN OUTCOME MEASURE

Stillbirth in a second pregnancy.

RESULTS

After adjusting for confounding factors, the odds of recurrence of stillbirth in a second pregnancy were found to be 1.94 (99% CI 1.29-2.92) compared with women who had had a live birth in their first pregnancy. Other factors associated with recurrence of stillbirth in a second pregnancy included placental abruption (adjusted OR 1.96; 99% CI 1.60-2.41), preterm delivery (adjusted OR 7.45; 99% CI 5.91-9.39) and low birthweight (adjusted OR 6.69; 99% CI 5.31-8.42). A Bayesian analysis using minimally informative normal priors found the risk of recurrence of stillbirth in a second pregnancy to be 1.59 (99% CI 1.10-2.33).

CONCLUSIONS

Women who have stillbirth in their first pregnancy have a higher risk of recurrence in their next pregnancy.

Medical risk factors in perinatal mortality in Kuwait: a case-controlled study from Al-Jahra district

This study is the first of its kind in Kuwait. It evaluates various risk factors associated with perinatal mortality (PNM) in the Al-Jahra district hospital during the period January 1995-December 1997. Risks associated with PNM were age above 30, parity above 8, history of abortion or perinatal death, lack of antenatal care, presence of chronic maternal disease, hydramnios, antepartum haemorrhage, breech presentation and low Apgar scores. The effect of the appropriate preventative programmes involving highlighting women at risk of perinatal mortality and probable intervention are discussed.