Fetus-Placenta-NewbornLife-table analysis of the risk of perinatal death at term and post term in singleton pregnancies☆,☆☆
Section snippets
Population
The numbers of singleton births at each gestational week at term and after term in Scotland were obtained through analysis of the Scottish Morbidity Record (maternity), a national database of pregnancy information that has been >99% complete since the late 1970s,11 between 1985 and 1996. Gestational age at birth was recorded in completed weeks’ gestation and was calculated from the estimated date of delivery in each woman’s clinical record, derived from her menstrual history and adjusted for
Results
There were 700,878 singleton births at 37 to 43 weeks’ gestation, excluding perinatal deaths caused by congenital abnormality, in Scotland between 1985 and 1996. Among this group there were 1230 antepartum stillbirths, 217 intrapartum stillbirths, and 425 neonatal deaths. There was no significant correlation (among primigravid women) between year of the birth and the proportion in whom labor was induced (overall, 25.8% had labor induced; r 2 vs year = 0.1; P =.22) or the proportion delivered at
Comment
A range of denominators have been used to estimate the probability of perinatal death in relation to gestational week, including all births6 and all ongoing pregnancies.4, 16 In this study the probabilities of different types of perinatal death were estimated with different denominators, and the different consequences of antepartum and intrapartum obstetric events were taken into account. These probabilities were summed, and the cumulative probability of perinatal death associated with birth at
Acknowledgements
I am grateful to Dr James W.T. Chalmers of the Information and Statistics Division, National Health Services in Scotland, Edinburgh, for providing data from the Scottish Morbidity Record and the Scottish Stillbirth and Neonatal Death Enquiry.
References (24)
- et al.
Risk of unexplained stillbirth at different gestational ages
Lancet
(1987) - et al.
Effect of gestational age on obstetric performance: when is “term” over?
Lancet
(1991) Post-term pregnancy: fetal considerations
- et al.
Post-term pregnancy
Induction of labor confers benefits in prolonged pregnancy
BJOG
(1994)Prospective risk of stillbirth
Obstet Gynecol
(1992)- et al.
Stillbirths and rate of neonatal deaths in 76,761 postterm pregnancies in Sweden, 1982-1991: a register study
Acta Obstet Gynecol Scand
(1997) - et al.
Effects of maternal age, parity, and smoking on the risk of stillbirth
BJOG
(1994) Statistical analysis of epidemiologic data
(1996)- et al.
Perinatal mortality in term and post-term births
Obstet Gynecol
(1980)
Medical causes on stillbirth certificates in England and Wales: distribution and results of hierarchical classifications tested by the Office for National Statistics
BJOG
Scottish maternity and neonatal records
Cited by (240)
The role of labor induction in modern obstetrics
2024, American Journal of Obstetrics and GynecologyPredicting and preventing stillbirth at term
2024, Seminars in PerinatologyRisk factors for stillbirth at term: an Italian area-based, prospective cohort study
2023, AJOG Global ReportsRisks of stillbirth, neonatal mortality, and severe neonatal morbidity by birthweight centiles associated with expectant management at term
2023, American Journal of Obstetrics and GynecologyLonger duration of gestation in term singletons is associated with better infant neurodevelopment
2023, Early Human DevelopmentImpact of restricting early-term deliveries on adverse neonatal outcomes: a statewide analysis
2023, American Journal of Obstetrics and Gynecology MFM
- ☆
Supported by the Wellcome Trust.
- ☆☆
Reprint requests: Gordon C.S. Smith, MD, University of Glasgow, Department of Obstetrics and Gynaecology, The Queen Mother’s Hospital, Yorkhill, Glasgow, United Kingdom G3 8SH.