Risk Factors Related to Intra Uterine Fetal Death in Iran, A Case-control Study

[摘要] Abstract:Intrauterinefetaldeath(IUFD)isatraumaticeventforthefamilywhichoccursinforabout1%ofallpregnancies.IncomparisonwithothercountriesthisrateisincreasinginIran.StatisticalreportsfromhealthcentersofFiroozabadestimatedtherateof2.2%peryear.Althoughobstetricalmanagementhasimprovedsignificantly,morethan50%ofthesecasesarestillunexplained.Thisresearchwasacase-controlstudytodetermineriskfactorsforintrauterinefetaldeath.Astandardquestionnairewasdesignedconsistingoffourmajorparts:Maternal,fetal,placentaandumbilicalcordfactors.Thequestionnairewasfiledbyusingmedicalrecords,between1998-2003.Samplesincluded450records,including150cases(thosewhohadIUFD)and300controls(thosewhohadlivenewborn).Generally,mother’seducation(P=0.000),andgestationalage(P=0.001)werefoundasmajorriskfactors.Moreover,seasonofdeliveryhadastatisticallysignificantassociationwithIUFD(P=0.000).Maternalriskfactorsincluded),receivingprenatalcare(P=0.001),andconsanguinity(P=0.004),pregnancycomplications(P=0.06),thehistoryofIUFD(P=0.000),rupturedamnioticfluid(P=0.007).Structuralabnormality(P=0.000)suchasimpairedneuraltube(P=0.000),fetalsex(P=0.000)andfetalweight(P=0.000)weremajorfetalriskfactors.Intrauterinegrowthretardation(IUGR)(P=0.000)andthirdtrimesterbleeding(P=0.000)weretheriskfactorrelatedtoplacentaandcordprolapse(P=0.01)wastheonlyumbilicalriskfactorforIUFD.Logisticregressionanalysiswasfurtherclarifiedtheroleofconfoundingvariables.Riskfactorsrelatedtomother,fetus,placentaandcordwereinvestigatedforIUFD.ItisdifficulttoidentifypreventablefactorsofIUFD,howeverconsultation,properprenatalcare,earlydiagnosisofcomplicationsandcarefulevaluationmayreducetheincidenceofIUFD.ThisstudysuggeststhatcertainmeasureshastobetakenbyIran’shealthMinistrytomakethewomenawareoftheriskfactorsrelatedtoIUFD.Alsoduringteachingsessionstomedicalstudentsandstaff,preventivemedicineshouldbetakenintoconsiderationwithemphasisonthelocalstudies

[学科分类] 基础医学

[关键词] Intrauterine Fetal Death;Iran;Risk Factors