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Perinatal death: worse obstetric and neonatal outcome in a subsequent pregnancy
1British Military Hospital, Rinteln.
A retrospective case-control study was undertaken of women with a history of a previous stillbirth or neonatal death, who subsequently delivered in BMH Rinteln. Their obstetric and neonatal outcome was compared to that of a control group of women of similar age and parity and its relationship to specific socio-economic factors assessed. Index patients had a worse obstetric and neonatal outcome. They were statistically significantly more likely to be admitted to hospital during their pregnancy (46% vs 26%), to have medical complications (58% vs 34%), to be delivered prematurely (16% vs 8%), and by Caesarean section (22% vs 9%). Their babies were more likely to have complications (28.8% vs 20.4%), to be of low birth weight (14% vs 7%), require intubation (11% vs 5%) and be admitted to the Special Care Baby Unit (SCBU) (13% vs 7%). Apart from small stature, no differences in socio-economic factors between the two groups could be identified. Index patients were four times more likely than controls to have their pregnancy terminated prematurely as a result of complications (6.7% vs 1.6%), but there was also a high level of obstetric intervention in the absence of clear medical indications. Although perinatal mortality was not statistically increased, the results were suspicious and it is concluded that these women should continue to be considered a high-risk group.
A retrospective case-control study was undertaken of women with a history of a previous stillbirth or neonatal death, who subsequently delivered in BMH Rinteln. Their obstetric and neonatal outcome was compared to that of a control group of women of similar age and parity and its relationship to specific socio-economic factors assessed. Index patients had a worse obstetric and neonatal outcome. They were statistically significantly more likely to be admitted to hospital during their pregnancy (46% vs 26%), to have medical complications (58% vs 34%), to be delivered prematurely (16% vs 8%), and by Caesarean section (22% vs 9%). Their babies were more likely to have complications (28.8% vs 20.4%), to be of low birth weight (14% vs 7%), require intubation (11% vs 5%) and be admitted to the Special Care Baby Unit (SCBU) (13% vs 7%). Apart from small stature, no differences in socio-economic factors between the two groups could be identified. Index patients were four times more likely than controls to have their pregnancy terminated prematurely as a result of complications (6.7% vs 1.6%), but there was also a high level of obstetric intervention in the absence of clear medical indications. Although perinatal mortality was not statistically increased, the results were suspicious and it is concluded that these women should continue to be considered a high-risk group.