Determining risk factors for intrapartum fetal death.

OBJECTIVE

To determine the antenatal and intrapartum risk factors for intrapartum fetal death (IPFD).

STUDY

DESIGN

We analyzed 72,875 singleton deliveries > 500 g between the years 1990 and 1997. In order to find independent factors contributing to IPFD, a multiple logistic regression model was constructed.

RESULTS

During the study period there were 64 cases of IPFD. Birth weight was inversely associated with IPFD in the multivariate analysis. Other significant factors in the multivariate analysis were mothers older than 35 years, polyhydramnios, congenital malformations, pathologic presentation, abruptio placentae and cord prolapse. No association was found with maternal diabetes or hypertension.

CONCLUSION

IPFD was significantly associated with low birth weight, older maternal age, polyhydramnios, congenital malformations and pathologic presentation. Direct causes were abruptio placentae and cord prolapse. Pregnancies in older women and those complicated by polyhydramnios and pathologic presentation should be carefully evaluated during pregnancy and delivery in order to decrease the incidence of IPFD.