Risk of Stillbirth and Infant Death Stratified by Gestational Age

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 2012 Aug 24

PMID 22914394

Citations 38

Authors

Melissa G Rosenstein

Yvonne W Cheng

Jonathan M Snowden

James M Nicholson

Aaron B Caughey

Affiliations

Soon will be listed here.

Abstract

Objective: To estimate the multiple dimensions of risk faced by pregnant women and their health care providers when comparing the risks of stillbirth at term with the risk of infant death after birth.

Methods: This is a retrospective cohort study that included all nonanomalous, term deliveries in the state of California from 1997 to 2006 (N=3,820,826). The study compared infant mortality rates after delivery at each week of term pregnancy with the rates of a composite fetal-infant mortality that would occur after expectant management for 1 additional week.

Results: The risk of stillbirth at term increases with gestational age from 2.1 per 10,000 ongoing pregnancies at 37 weeks of gestation up to 10.8 per 10,000 ongoing pregnancies at 42 weeks of gestation. At 38 weeks of gestation, the risk of expectant management carries a similar risk of death as delivery, but at each later gestational age, the mortality risk of expectant management is higher than the risk of delivery (39 weeks of gestation: 12.9 compared with 8.8 per 10,000; 40 weeks of gestation: 14.9 compared with 9.5 per 10,000; 41 weeks of gestation: 17.6 compared with 10.8 per 10,000).

Conclusion: Infant mortality rates at 39, 40, and 41 weeks of gestation are lower than the overall mortality risk of expectant management for 1 week.

Citing Articles

Maternal and Perinatal Outcome After Induction of Labor Expectant Management in Low-risk Pregnancies Beyond Term.

Pfleiderer M, Gilman E, Gruttner B, Ratiu J, Mallmann P, Baek S In Vivo. 2023; 38(1):299-307.

PMID: 38148072 PMC: 10756460. DOI: 10.21873/invivo.13439.

Gestational Age and Birth Outcomes in Term Singleton Pregnancies Conceived With Infertility Treatment.

Hamilton I, Martin N, Liu J, DeFranco E, Rossi R JAMA Netw Open. 2023; 6(8):e2328335.

PMID: 37566418 PMC: 10422180. DOI: 10.1001/jamanetworkopen.2023.28335.

Associations of Prenatal Agricultural Farm Work with Fetal Overgrowth and Pregnancy Complications in State of Arizona Birth Records.

Parra K, Harris R, Farland L, Beamer P, Furlong M J Occup Environ Med. 2023; 65(8):635-642.

PMID: 37167931 PMC: 10523987. DOI: 10.1097/JOM.0000000000002877.

Maternal and fetal risk factors for stillbirth in Otjozondjupa Region, Namibia: a case-control study.

Shikesho R, Amakali-Nauiseb T, Nyarko K Pan Afr Med J. 2023; 44:73.

PMID: 37159625 PMC: 10162887. DOI: 10.11604/pamj.2023.44.73.26724.

Antepartum and intrapartum stillbirth rates across gestation: a cross-sectional study using the revised foetal death reporting system in the U.S.

Ncube C, McCormick S, Badon S, Riley T, Souter V BMC Pregnancy Childbirth. 2022; 22(1):885.

PMID: 36447143 PMC: 9706921. DOI: 10.1186/s12884-022-05185-x.

References

Zhang X, Kramer M . Variations in mortality and morbidity by gestational age among infants born at term. J Pediatr. 2008; 154(3):358-62, 362.e1. DOI: 10.1016/j.jpeds.2008.09.013. View

Halloran D, Alexander G . Preterm delivery and age of SIDS death. Ann Epidemiol. 2006; 16(8):600-6. DOI: 10.1016/j.annepidem.2005.11.007. View

Dietz P, England L, Callaghan W, Pearl M, Wier M, Kharrazi M . A comparison of LMP-based and ultrasound-based estimates of gestational age using linked California livebirth and prenatal screening records. Paediatr Perinat Epidemiol. 2007; 21 Suppl 2:62-71. DOI: 10.1111/j.1365-3016.2007.00862.x. View

Ananth C . Menstrual versus clinical estimate of gestational age dating in the United States: temporal trends and variability in indices of perinatal outcomes. Paediatr Perinat Epidemiol. 2007; 21 Suppl 2:22-30. DOI: 10.1111/j.1365-3016.2007.00858.x. View

Hutcheon J, Lisonkova S, Magee L, von Dadelszen P, Woo H, Liu S . Optimal timing of delivery in pregnancies with pre-existing hypertension. BJOG. 2010; 118(1):49-54. DOI: 10.1111/j.1471-0528.2010.02754.x. View

Oestergaard M, Inoue M, Yoshida S, Mahanani W, Gore F, Cousens S . Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS Med. 2011; 8(8):e1001080. PMC: 3168874. DOI: 10.1371/journal.pmed.1001080. View

Bruckner T, Cheng Y, Caughey A . Increased neonatal mortality among normal-weight births beyond 41 weeks of gestation in California. Am J Obstet Gynecol. 2008; 199(4):421.e1-7. DOI: 10.1016/j.ajog.2008.05.015. View

Reddy U, Ko C, Willinger M . Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol. 2006; 195(3):764-70. DOI: 10.1016/j.ajog.2006.06.019. View

Cheng Y, Nicholson J, Nakagawa S, Bruckner T, Washington A, Caughey A . Perinatal outcomes in low-risk term pregnancies: do they differ by week of gestation?. Am J Obstet Gynecol. 2008; 199(4):370.e1-7. DOI: 10.1016/j.ajog.2008.08.008. View

10.

Clark S, Miller D, Belfort M, Dildy G, Frye D, Meyers J . Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol. 2008; 200(2):156.e1-4. DOI: 10.1016/j.ajog.2008.08.068. View

11.

Chen H, Chauhan S, Salm Ward T, Mori N, Gass E, Cisler R . Aberrant fetal growth and early, late, and postneonatal mortality: an analysis of Milwaukee births, 1996-2007. Am J Obstet Gynecol. 2011; 204(3):261.e1-261.e10. DOI: 10.1016/j.ajog.2010.11.040. View

12.

Pearl M, Wier M, Kharrazi M . Assessing the quality of last menstrual period date on California birth records. Paediatr Perinat Epidemiol. 2007; 21 Suppl 2:50-61. DOI: 10.1111/j.1365-3016.2007.00861.x. View

13.

Kaimal A, Little S, Odibo A, Stamilio D, Grobman W, Long E . Cost-effectiveness of elective induction of labor at 41 weeks in nulliparous women. Am J Obstet Gynecol. 2010; 204(2):137.e1-9. DOI: 10.1016/j.ajog.2010.08.012. View

14.

Savitz D, Terry Jr J, Dole N, Thorp Jr J, Siega-Riz A, Herring A . Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. Am J Obstet Gynecol. 2002; 187(6):1660-6. DOI: 10.1067/mob.2002.127601. View

15.

Donovan E, Besl J, Paulson J, Rose B, Iams J . Infant death among Ohio resident infants born at 32 to 41 weeks of gestation. Am J Obstet Gynecol. 2010; 203(1):58.e1-5. DOI: 10.1016/j.ajog.2010.01.071. View

16.

Spong C, Iams J, Goldenberg R, Hauck F, Willinger M . Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality. Obstet Gynecol. 2011; 117(4):948-955. DOI: 10.1097/AOG.0b013e318211726f. View

17.

Ehrenthal D, Hoffman M, Jiang X, Ostrum G . Neonatal outcomes after implementation of guidelines limiting elective delivery before 39 weeks of gestation. Obstet Gynecol. 2011; 118(5):1047-1055. DOI: 10.1097/AOG.0b013e3182319c58. View

18.

Tita A, Landon M, Spong C, Lai Y, Leveno K, Varner M . Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009; 360(2):111-20. PMC: 2811696. DOI: 10.1056/NEJMoa0803267. View

19.

Greene M . Making small risks even smaller. N Engl J Med. 2009; 360(2):183-4. DOI: 10.1056/NEJMe0810120. View

20.

Reddy U, Bettegowda V, Dias T, Yamada-Kushnir T, Ko C, Willinger M . Term pregnancy: a period of heterogeneous risk for infant mortality. Obstet Gynecol. 2011; 117(6):1279-1287. PMC: 5485902. DOI: 10.1097/AOG.0b013e3182179e28. View