Risk of Recurrent Stillbirth in Subsequent Pregnancies.

Szczegóły
Abstrakt

Tytuł:: Risk of Recurrent Stillbirth in Subsequent Pregnancies.
Autorzy:: Lamont K; Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, University of Aberdeen, and the Medical Statistics Team, University of Aberdeen, Aberdeen, United Kingdom ; the Finnish Institute for Health and Welfare Finland, Helsinki, Finland; and the Directorate for Health Information and Research, Guardamangia, Malta.
Scott NW
Gissler M
Gatt M
Bhattacharya S
Źródło:: Obstetrics and gynecology [Obstet Gynecol] 2022 Jan 01; Vol. 139 (1), pp. 31-40.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: 2004- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York.
MeSH Terms:: Stillbirth/*epidemiology
Adult ; Cohort Studies ; Female ; Finland/epidemiology ; Humans ; Malta/epidemiology ; Parity ; Pregnancy ; Proportional Hazards Models ; Registries ; Risk Factors ; Scotland/epidemiology ; Social Class
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Entry Date(s):: Date Created: 20211202 Date Completed: 20220103 Latest Revision: 20230706
Update Code:: 20240105
DOI:: 10.1097/AOG.0000000000004626
PMID:: 34856561
: Czasopismo naukowe

Objective: To compare the prospective risk of stillbirth between women with and without a stillbirth in their first pregnancy.
Methods: We conducted a cohort study using perinatal data from Finland, Malta, and Scotland. Women who had at least two singleton deliveries were included. The exposed and unexposed cohorts comprised women with a stillbirth and live birth in their first pregnancy, respectively. The risk of stillbirth in any subsequent pregnancy was assessed using a Cox proportional hazards model. Time-to-event analyses were conducted to investigate whether first pregnancy outcome had an effect on time to or the number of pregnancies preceding subsequent stillbirth.
Results: The pooled data set included 1,064,564 women, 6,288 (0.59%) with a stillbirth and 1,058,276 with a live birth in a first pregnancy. Compared with women with a live birth, women with a stillbirth in the first pregnancy were more likely to have a subsequent stillbirth (adjusted hazard ratio [aHR] 2.25, 95% CI 1.86-2.72). For women with more than two pregnancies, the difference in risk of subsequent stillbirth between the two groups increased with the number of subsequent pregnancies. Maternal age younger than 25 years or 40 years and older, smoking, low socioeconomic status, not having a partner, pre-existing diabetes, preeclampsia, placental abruption, or delivery of a growth-restricted neonate in a first pregnancy were independently associated with subsequent stillbirth. Compared with women with a live birth in the first pregnancy, women with a stillbirth were more likely to have another pregnancy within 1 year. The absolute risk of stillbirth in a subsequent pregnancy for women with stillbirth and live birth in a first pregnancy were 2.5% and 0.5%, respectively.
Conclusion: Compared with women with a live birth in a first pregnancy, women with a stillbirth have a higher risk of subsequent stillbirth irrespective of the number and sequence of the pregnancies. Despite high relative risk, the absolute risk of recurrence was low.
Competing Interests: Financial Disclosure Kathleen Lamont was awarded an Elphinstone scholarship from the university of Aberdeen, Scotland. In addition, money from an NHS Grampian endowment fund financed storage of data. Sohinee Bhattacharya reports that money was paid to their institution from the NHS Grampian Endowment fund, Medical Research Scotland, and the Wellcome Trust ISSF fund. Sohinee Bhattacharya's husband has coauthored previous publications based on a similar data set. He is the Head of School of Medicine, Medical Sciences and Nutrition at the University of Aberdeen where she is also employed. The other authors did not report any potential conflicts of interest.
(Copyright © 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

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