Perinatal death and neurological damage as a sequential chain of poor outcome.

OBJECTIVE

We investigated the risk factors of perinatal death and neurological damage.

METHODS

Perinatal death and neurological damage were retrospectively investigated using a population-based study of 108 024 deliveries from 1998 to 2007. Main factors studied were asphyxia, growth restriction and preterm delivery < 34 weeks of gestation, since these three factors were most often associated with poor prognosis. The impact of each factor was identified by multiple regression analyses.

RESULTS

There were 459 perinatal deaths (4.3/1000) and 220 neurological damages (2.0/1000). Preterm delivery accounted for 50% of perinatal deaths and neurological damage, whereas it constituted 2.6% of total births. Multiple regression analyses showed that prematurity < 34 weeks (10-fold), asphyxia (10-fold) and growth restriction (2-fold) were independent and significant risk factors associated with poor outcomes, and that the magnitude was similar throughout the three consecutive critical events of fetal death, neonatal death and neurological damage.

CONCLUSIONS

Prematurity < 34 weeks, asphyxia and growth restriction are independent and persistent risk factors from perinatal death to neurological damage.