Stillbirths in China: a nationwide survey.


Journal

BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741

Informations de publication

Date de publication:
01 2021
Historique:
accepted: 28 07 2020
pubmed: 10 8 2020
medline: 12 1 2021
entrez: 10 8 2020
Statut: ppublish

Résumé

To estimate a stillbirth rate at 24 or more gestational weeks in 2015-2016 and to explore potentially preventable causes in China. A multi-centre cross-sectional study. Ninety-six hospitals distributed in 24 (of 34) provinces in China. A total of 75 132 births at 24 completed weeks of gestation or more. COX Proportional Hazard Models were performed to examine risk factors for antepartum and intrapartum stillbirths. Population attributable risk percentage was calculated for major risk factors. Correspondence analysis was used to explore region-specific risk factors for stillbirths. Stillbirth rate and risk factors for stillbirth. A total of 75 132 births including 949 stillbirths were used for the final analysis, giving a weighted stillbirth rate of 13.2 per 1000 births (95% CI 7.9-18.5). Small for gestational age (SGA) and pre-eclampsia/eclampsia increased antepartum stillbirths by 26.2% and 11.7%, respectively. Fetal anomalies increased antepartum and intrapartum stillbirths by 17.9% and 7.4%, respectively. Overall, 31.4% of all stillbirths were potentially preventable. Advanced maternal age, pre-pregnant obesity, chronic hypertension and diabetes mellitus were important risk factors in East China; low education and SGA were major risk factors in Northwest, Southwest, Northeast and South China; and pre-eclampsia/eclampsia and intrapartum complications were significant risk factors in Central China. The prevalence of stillbirth was 13.2 per 1000 births in China in 2015-2016. Nearly one-third of all stillbirths may be preventable. Strategies based on regional characteristics should be considered to reduce further the burden of stillbirths in China. The stillbirth rate was 13.2 per 1000 births in China in 2015-2016 and nearly one-third of all stillbirths may be preventable.

Identifiants

pubmed: 32770714
doi: 10.1111/1471-0528.16458
pmc: PMC7754392
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

67-76

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Shanghai Municipal Health Commission
ID : GWIV-26.2
Pays : International

Informations de copyright

© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

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Auteurs

J Zhu (J)

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

J Zhang (J)

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

H Xia (H)

Department of Obstetrics, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

J Ge (J)

Department of Obstetrics, Shijiazhuang Obstetrics and Gynecology Hospital, Hebei, China.

X Ye (X)

Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Jiangsu, China.

B Guo (B)

Department of Obstetrics, The Maternal and Child Health Hospital of Dongchangfu District, Shangdong, China.

M Liu (M)

Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

L Dai (L)

Department of Obstetrics, The Maternal and Child Healthcare Hospital of Xiangtan, Hunan, China.

L Zhang (L)

Department of Obstetrics, Qihetai Maternal and Child Health Hospital, Heilongjiang, China.

L Chen (L)

Department of Obstetrics, Fujian Provincial Maternity and Children's Hospital, Fujian, China.

Y Wang (Y)

Department of Obstetrics and Gynecology, Suzhou Municipal Hospital, Nanjing University Medical School, Jiangsu, China.

X Wang (X)

Department of Obstetrics and Gynecology, Traditional Chinese Medicine Integrated Hospital of Tongzhou District, Beijing, China.

H Liu (H)

Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an Jiao Tong University, Shaanxi, China.

C Chen (C)

Department of Obstetrics, Maternity and Child Care Center of Xingyang, Henan, China.

Y Wang (Y)

Department of Obstetrics and Gynecology, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, China.

G Wang (G)

Department of Obstetrics, Inner Mongolia Maternity and Child Health Care Hospital, Hohhot, Inner Mongolia Autonomous Region, China.

M Cai (M)

Department of Obstetrics, Changsha Hospital for Maternal and Child Health Care, Hunan, China.

X Yang (X)

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

F Li (F)

Department of Obstetrics, Haidian Maternal and Child Health Hospital, Beijing, China.

C Fan (C)

Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Hubei, China.

Y Ruan (Y)

Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

L Yu (L)

Department of Obstetrics and Gynecology, Jinhua People's Hospital, Zhejiang, China.

R Zhang (R)

Department of Obstetrics and Gynecology, Wenling Maternal and Child Health Hospital, Zhejiang, China.

H Xu (H)

Department of Obstetrics, Shaoxing Maternal and Child Health Hospital, Zhejiang, China.

J Zhang (J)

Department of Obstetrics and Gynecology, The Fifth Hospital of Xiamen, Fujian, China.

X Ma (X)

Department of Obstetrics, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China.

D Yuan (D)

Department of Obstetrics, Gaizhou Maternal and Child Health Hospital, Liaoning, China.

Y Zhu (Y)

Department of Obstetrics and Gynecology, Jiangyin People's Hospital, Southeast University School of Medicine, Jiangsu, China.

D Wang (D)

Department of Obstetrics and Gynecology, The First Hospital Affiliated to Army Medical University, Chongqing, China.

A P Betran (AP)

UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland.

H Qi (H)

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

T Duan (T)

Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

J Zhang (J)

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

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Classifications MeSH