Infant mortality and subsequent risk of stillbirth: a retrospective cohort study.
Summary of "Infant mortality and subsequent risk of stillbirth: a retrospective cohort study."
Please cite this paper as: August E, Salihu H, Weldeselasse H, Biroscak B, Mbah A, Alio A. Infant mortality and subsequent risk of stillbirth: a retrospective cohort study. BJOG 2011;
10.1111/j.1471-0528.2011.03137.x. Objective To examine the association between infant mortality in a first pregnancy and risk for stillbirth in a second pregnancy. Design Population-based, retrospective cohort study. Setting Maternally linked cohort data files for the state of Missouri. Population Women who had two singleton pregnancies in Missouri during the period 1989-2005 (n = 320 350). Methods Women whose first pregnancy resulted in infant death were compared with those whose infant from the first pregnancy survived the first year of life. The Kaplan-Meier product limit estimator was employed to compare probabilities for stillbirth in the second pregnancy between both groups of women. Adjusted hazard ratios (AHRs) and 95% confidence intervals (95% CIs) were generated to assess the association between infant mortality in the first pregnancy and stillbirth in the second pregnancy. Main outcome measures Exposure was defined as infant mortality in the first pregnancy, and the outcome was defined as stillbirth in the second pregnancy. Results Women with prior infant deaths were about three times as likely to experience stillbirth in their subsequent pregnancy (AHR 2.91; 95% CI 2.02-4.18). White women with a previous infant death were nearly twice as likely to experience a subsequent stillbirth, compared with white women with a surviving infant (AHR 1.96; 95% CI 1.13-3.39). Black women with a previous infant death were more than four times as likely to experience subsequent stillbirth, compared with black women with a surviving infant (AHR 4.28; 95% CI 2.61-6.99). Conclusions Previous infant mortality results in an elevated risk for subsequent stillbirth, with the most profound increase observed among black women. Interconception care should consider prior childbearing experiences to avert subsequent fetal loss.
Department of Community and Family Health, College of Public Health Department of Epidemiology and Biostatistics, College of Public Health Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA Department
This article was published in the following journal.
Name: BJOG : an international journal of obstetrics and gynaecology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21933338
- DOI: http://dx.doi.org/10.1111/j.1471-0528.2011.03137.x
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Medical and Biotech [MESH] Definitions
Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are CASE-CONTROL STUDIES; COHORT STUDIES; and CROSS-SECTIONAL STUDIES.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.
Variation in health status arising from different causal factors to which each birth cohort in a population is exposed as environment and society change.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.