بررسي عوامل خطرزاي مرگ داخل رحمي جنين در زنان مراجعه كننده به مراكز بهداشتي درماني دانشگاه علوم پزشكي ايران (تهران ،سال هاي 1376 تا 1380)

Survey on Intrauterine Fetal Death Risk Factors in Women Referred-to .1feafth Centers of Iran University of Medical Sciences(1997-2001)

The aim of this study was to identify risk factors of intrauterine fetal death. A retrospective analysis was conducted on 1288 stillbirth as case and 3888 live birth as control subjects, from first of March 1997 to the end of February 2001. Intrauterine fetal death was defined by an estimated gestational age more than 20 weeks, or fetal weight more than 500gm. The goal of the present was to find out the risk factors for intrauterine fetal death. All women who had stillbirths, as described herein, were identified through the medical records and the records were census selection for each case. Three records were simple randomly extracted for control group. Data were obtained from medical records and the collection took three months. Uncompleted records were excluded. Adjusted odds ratios and 95% confidence interval for each qualitative variable related to intrauterine fetal death were significant. Logistic regression analysis showed that among variables which were different between two groups the following variables were associated with intrauterine fetal death. The variables were: parity (p=0.024), abortion (p=0.012), low birth weight (p=0.0001), dystocia (p=0.041), glucosuria (p=0.002), proteinuria (p=0.016), congenital abnormalities(p=0.0001), fetal distress (p=0.003), hydraminious (p=0.003), true cord node (p=0.002), cord prolaps (p=0.002) and abnormal cord coiling around the neck (p=0.016). Intensive antenatal care and increased monitoring for women with history of stillbirth and other problems are the most important steps for decreasing intrauterine fetal death. Early diagnosis and prompt deliveries for women with forthcoming problems might be helpful in reducing the number of intrauterine fetal death. Prenatal care givers should also be made aware of such problems for taking actions in emergency cases.