American Journal of Epidemiology Vol. 137, No. 11: 1177-1189
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
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Risk Factors for Antepartum and Intrapartum Stillbirth
1Epidemiology Brach, Division of Biometry and Risk Assessment, National Institute of Environmental Health Sciences Research Triangle Park, NC
2Statistics and Biomathematics Branch, Division of Biometry and Risk Assessment, National Institute of Environmental Health Sciences Research Triangle Park, NC
Reprint requests to Dr. Ruth E. Little, Epidemiology Branch, Division of Biometry and Risk Assessment, National Institute of Environmental Health Sciences, Box 12233, MD A3-05, Research Triangle Park, NC 27709.
Data from manied women who participated in the 1980 NatIonal Natality Survey and the National Fetal Mortality Survey were used for a case-control study of antepartum and intrapartum stillbirth. Risk factors were identified by comparing antepartum deaths and intrapartum deaths to Iivebirths in separate logistic regression analyses. Risk of antepartum death was increased among black mothers, those having their first delivery, those aged 35 years or more, and those with less education. Smoking cigarettes was associated with increased risk. For intrapartum deaths, total abstention from alcohol during pregnancy was associated with increased risk in the best-fitting logistic model, as was first delivery. Body mass index was logit-linear in both models, with lower body mass index associated with lower risk. While some of these factors have already been associated with stillbirth, others have not; the new associations may reflect the continuum of loss over the gestational period, bias in the study, or clues to mechanisms by which the risk of death, before or during parturition, is increased.
alcohol drinking; body mass index; fetal death; labor; maternal age; parity; race; smoking
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