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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Wanda D. Barfield, MD, MPH, Division of Reproductive Health/ NCCDPHP, Centers for Disease Control and Prevention, Atlanta, GA, 4770 Buford Highway, Mailstop K-23, Atlanta, GA 30341, (770)488-6273, wjb5@cdc.gov, Kay Tomashek, MD, MPH, Division of Reproductive Health, Centers for Disease Control & Prevention, 4770 Buford Highway, Mailstop K-23, Atlanta, GA 30341-3724, and Solomon Iyasu, MBBS, MPH, Division of Reproductive Health/ NCCDPHP, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-23, Atlanta, GA 30341.
Nearly 13,000 stillbirths (fetal deaths at ³ 28 weeks gestation) occur annually in the United States, but they are seldom studied. Little is known how stillbirths differ from early neonatal deaths (deaths within the first week of life). We examined these deaths and associated maternal risk factors to help focus on prevention strategies. We analyzed fetal and early neonatal deaths at ³ 28 weeks gestation using U.S. fetal death and linked infant birth-death certificate data (1995-1998). We used univariate analyses and odds ratios to compare stillbirths with early neonatal deaths by number, rate (deaths per 1,000 live births + fetal deaths), selected maternal and fetal/infant characteristics, and maternal medical conditions and complications. During 1995-1998, there were 53,103 stillbirths (rate=3.4) and 19,941 early neonatal deaths (rate=1.8). The mother’s mean age and education were similar for both groups. Mothers who had stillbirths were less likely to have had prenatal care than mothers with early neonatal deaths (4.5% vs. 3.6%). Stillbirths weighed less at delivery than neonates who died (2,151g vs. 2,266g, p< 0.01). Stillbirths were more common than early neonatal deaths among women who smoked or used alcohol (OR=1.2 and 1.4, respectively). Mothers with high-risk medical conditions and complications were more likely to have stillbirths than neonatal deaths. These factors were more common among black mothers than among women of other races. Poor maternal health and high-risk behaviors increase the risk for stillbirths. Prevention should focus on maternal health to reduce stillbirths and associated racial disparities.
Learning Objectives:
Keywords: Perinatal Outcomes, Fetal Mortality
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.