Journal Article

Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders

Neri, Isabella, Pozzi, Elisa, Pedrielli, Giulia, Facchinetti, Fabio, Serena, Caterina, Mecacci, Federico, Vergani, Patrizia, Monari, Francesca

2016

Overview

To evaluate outcome in the pregnancy following a stillbirth (SB) by a placental vascular disorders. A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks) between 2005 and June 2013, in 3 Italian University Hospitals. Causes of SB were previously identified after extensive investigations. Pregnant women were enrolled within the first trimester. The main outcome was \"adverse neonatal outcome\", including perinatal death, fetal growth restriction, early preterm birth <33+6 weeks, hypoxic-ischemic encephalopathy, intracranial hemorrhage or respiratory distress. Out of 364 index pregnancies, 320 women (87.9%) had a subsequent pregnancy during the study period. Forty-seven had an early pregnancy loss. Out of 273 babies, 67 (24.5%) had an adverse perinatal outcome, including 1 SB and 1 early neonatal death (3.7/1000). Women who had a SB related to placental vascular disorders (39.6%), were at higher risk of an adverse neonatal outcome compared with women whose SB was unexplained or resulted from other causes (Adj. OR = 2.1, 95%CI: 1.2-3.8). Moreover, also obesity independently predicts an adverse perinatal outcome (Adj OR = 2.1, 95%CI: 1.1-4.3). When previous SB is related to placental vascular disorders there is a high risk for adverse neonatal outcomes in the subsequent pregnancy. Maternal obesity is an additional risk factor.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abortion / Adult / Age / Babies / Biology and Life Sciences / Birth weight / Births / Brain damage / Causes of / Classification / Complications and side effects / Disorders / Encephalopathy / Female / Fetal Growth Retardation / Fetuses / Gynecology / Health aspects / Health risk assessment / Hemorrhage / Humans / Hypoxia / Infant, Newborn / Ischemia / Medicine and Health Sciences / Natural history / Neonates / Newborn babies / Obesity / Obstetrics / Perinatal Death - etiology / Placenta / Placenta diseases / Placenta Diseases - physiopathology / Population / Pregnancy / Pregnancy Complications - etiology / Pregnancy Outcome / Premature birth / Premature Birth - etiology / Prospective Studies / Risk factors / Stillbirth / Stillbirth - epidemiology / Studies / Vascular Diseases - complications / Womens health