The Risk of Perinatal Mortality in Nulliparous Women Compared to Primiparous Women at Term.

التفاصيل البيبلوغرافية
العنوان:	The Risk of Perinatal Mortality in Nulliparous Women Compared to Primiparous Women at Term.
المؤلفون:	Devabhaktuni A; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon., Pilliod RA; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon., Caughey AB; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon., Valent AM; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
المصدر:	American journal of perinatology [Am J Perinatol] 2024 Feb; Vol. 41 (3), pp. 270-275. Date of Electronic Publication: 2021 Oct 19.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8405212 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8785 (Electronic) Linking ISSN: 07351631 NLM ISO Abbreviation: Am J Perinatol Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: New York, NY : Thieme-Stratton, 1983-
مواضيع طبية MeSH:	Stillbirth/epidemiology , Perinatal Death, Pregnancy ; Infant ; Infant, Newborn ; Female ; Humans ; Perinatal Mortality ; Birth Weight ; Retrospective Studies
مستخلص:	Objective: The aim of this study was to determine the rate of perinatal mortality among nulliparous women compared with primiparous women at term and further characterize the risk of stillbirth by each week of gestation. Study Design: This is a retrospective cohort study of all term, singleton, nonanomalous births comparing perinatal mortality (stillbirth and neonatal death [NND]) between primiparous (parity = 1, with no history of abortion) and nulliparous (parity = 0) women who delivered in California between 2007 and 2011. Chi-squared tests and multivariable logistic regression analyses were performed to determine the frequencies and strength of association of perinatal mortality with parity, adjusting for maternal age, race, body mass index, pregestational diabetes, chronic hypertension, fetal sex, smoking status, and socioeconomic status. The risk of stillbirth at each gestational age at term was calculated using a pregnancies-at-risk life table method. A p -value less than 0.05 was used to indicate statistical significance. Results: Of 1,317,761 total deliveries, 765,995 (58.1%) were to nulliparous women and 551,766 (41.9%) were to primiparous women with one prior birth. Nulliparous women had increased odds of stillbirth (adjusted odds ratio [aOR], 3.30; 95% confidence interval [CI], 2.93-3.72) and NND (aOR, 1.54; 95% CI, 1.19-1.98) compared with primiparous women. The risk of stillbirth in nulliparous women was greater at every gestational age between 37 ^0/7 and 41 ^0/7 weeks compared with primiparous women. Nulliparous women also had increased odds of small for gestational age infants at less than 10% birth weight (aOR, 1.76; 95% CI, 1.72-1.79), less than 5% birth weight (aOR, 1.91; 95% CI, 1.86-1.98), and less than 3% birth weight (aOR, 2.02; 95% CI, 1.93-2.11). Conclusion: Perinatal mortality is significantly greater in nulliparous women compared with primiparous women with term deliveries. These findings suggest that low-risk nulliparous women may require increased surveillance. There may be a role in improving maternal health by maximizing physiologic adaptation in nulliparous women. Key Points: · Parity is associated with perinatal mortality.. · Perinatal mortality is significantly greater in nulliparous women compared with primiparous women.. · The risk of stillbirth in nulliparous women is greater at every gestational age compared with primiparous women.. Competing Interests: None declared. (Thieme. All rights reserved.)
تواريخ الأحداث:	Date Created: 20211019 Date Completed: 20240208 Latest Revision: 20240208
رمز التحديث:	20240208
DOI:	10.1055/a-1673-0527
PMID:	34666381
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1098-8785
DOI:	10.1055/a-1673-0527