Obstetric outcomes subsequent to intrauterine death in the first pregnancy

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Abstract

Objective To compare obstetric outcomes in the pregnancy subsequent to intrauterine death with that following live birth in first pregnancy.

Design Retrospective cohort study.

Setting Grampian region of Scotland, UK.

Population All women who had their first and second deliveries in Grampian between 1976 and 2006.

Methods All women delivering for the first time between 1976 and 2002 had follow up until 2006 to study their next pregnancy. Those women who had an intrauterine death in their first pregnancy formed the exposed cohort, while those who had a live birth formed the unexposed cohort.

Main outcome measures Maternal and neonatal outcomes in the second pregnancy, including pre-eclampsia, placental abruption, induction of labour, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth.

Results The exposed cohort (n = 364) was at increased risk of pre-eclampsia (OR 3.1, 95% CI 1.7–5.7); placental abruption (OR 9.4, 95% CI 4.5–19.7); induction of labour (OR 3.2, 95% CI 2.4–4.2); instrumental delivery (OR 2.0, 95% CI 1.4–3.0); elective (OR 3.1, 95% CI 2–4.8) and emergency caesarean deliveries (OR 2.1, 95% CI 1.5–3.0); and prematurity (OR 2.8, 95% CI 1.9–4.2), low birthweight (OR 2.8, 95% CI 1.7–4.5) and malpresentation (OR 2.8, 95% CI 2.0–3.9) of the infant as compared with the unexposed cohort (n = 33 715). The adjusted odds ratio for stillbirth was 1.2 and 95% CI 0.4–3.4.

Conclusion While the majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a high-risk group with an increased incidence of adverse maternal and neonatal outcomes.

Original languageEnglish
Pages (from-to)269-274
Number of pages6
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume115
Issue number2
Early online date7 Dec 2007
DOIs
Publication statusPublished - Jan 2008

Fingerprint

Obstetrics
Stillbirth
Live Birth
Induced Labor
Abruptio Placentae
Pregnancy
Pre-Eclampsia
Mothers
High-Risk Pregnancy
Scotland
Pregnancy Outcome
Emergencies
Cohort Studies
Retrospective Studies
Odds Ratio
Outcome Assessment (Health Care)
Incidence
Population

Keywords

  • Intrauterine death
  • obstetric outcome
  • stillbirth
  • subsequent pregnancy

Cite this

@article{1607fca5899f4f7f8afc64cae65a05de,
title = "Obstetric outcomes subsequent to intrauterine death in the first pregnancy",
abstract = "Objective To compare obstetric outcomes in the pregnancy subsequent to intrauterine death with that following live birth in first pregnancy. Design Retrospective cohort study. Setting Grampian region of Scotland, UK. Population All women who had their first and second deliveries in Grampian between 1976 and 2006. Methods All women delivering for the first time between 1976 and 2002 had follow up until 2006 to study their next pregnancy. Those women who had an intrauterine death in their first pregnancy formed the exposed cohort, while those who had a live birth formed the unexposed cohort. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, including pre-eclampsia, placental abruption, induction of labour, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. Results The exposed cohort (n = 364) was at increased risk of pre-eclampsia (OR 3.1, 95{\%} CI 1.7–5.7); placental abruption (OR 9.4, 95{\%} CI 4.5–19.7); induction of labour (OR 3.2, 95{\%} CI 2.4–4.2); instrumental delivery (OR 2.0, 95{\%} CI 1.4–3.0); elective (OR 3.1, 95{\%} CI 2–4.8) and emergency caesarean deliveries (OR 2.1, 95{\%} CI 1.5–3.0); and prematurity (OR 2.8, 95{\%} CI 1.9–4.2), low birthweight (OR 2.8, 95{\%} CI 1.7–4.5) and malpresentation (OR 2.8, 95{\%} CI 2.0–3.9) of the infant as compared with the unexposed cohort (n = 33 715). The adjusted odds ratio for stillbirth was 1.2 and 95{\%} CI 0.4–3.4. Conclusion While the majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a high-risk group with an increased incidence of adverse maternal and neonatal outcomes.",
keywords = "Intrauterine death, obstetric outcome, stillbirth, subsequent pregnancy",
author = "Black, {Mairead Eileen} and Ashalatha Shetty and Sohinee Bhattacharya",
year = "2008",
month = "1",
doi = "10.1111/j.1471-0528.2007.01562.x",
language = "English",
volume = "115",
pages = "269--274",
journal = "BJOG-An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "John Wiley & Sons, Ltd (10.1111)",
number = "2",

}

TY - JOUR

T1 - Obstetric outcomes subsequent to intrauterine death in the first pregnancy

AU - Black, Mairead Eileen

AU - Shetty, Ashalatha

AU - Bhattacharya, Sohinee

PY - 2008/1

Y1 - 2008/1

N2 - Objective To compare obstetric outcomes in the pregnancy subsequent to intrauterine death with that following live birth in first pregnancy. Design Retrospective cohort study. Setting Grampian region of Scotland, UK. Population All women who had their first and second deliveries in Grampian between 1976 and 2006. Methods All women delivering for the first time between 1976 and 2002 had follow up until 2006 to study their next pregnancy. Those women who had an intrauterine death in their first pregnancy formed the exposed cohort, while those who had a live birth formed the unexposed cohort. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, including pre-eclampsia, placental abruption, induction of labour, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. Results The exposed cohort (n = 364) was at increased risk of pre-eclampsia (OR 3.1, 95% CI 1.7–5.7); placental abruption (OR 9.4, 95% CI 4.5–19.7); induction of labour (OR 3.2, 95% CI 2.4–4.2); instrumental delivery (OR 2.0, 95% CI 1.4–3.0); elective (OR 3.1, 95% CI 2–4.8) and emergency caesarean deliveries (OR 2.1, 95% CI 1.5–3.0); and prematurity (OR 2.8, 95% CI 1.9–4.2), low birthweight (OR 2.8, 95% CI 1.7–4.5) and malpresentation (OR 2.8, 95% CI 2.0–3.9) of the infant as compared with the unexposed cohort (n = 33 715). The adjusted odds ratio for stillbirth was 1.2 and 95% CI 0.4–3.4. Conclusion While the majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a high-risk group with an increased incidence of adverse maternal and neonatal outcomes.

AB - Objective To compare obstetric outcomes in the pregnancy subsequent to intrauterine death with that following live birth in first pregnancy. Design Retrospective cohort study. Setting Grampian region of Scotland, UK. Population All women who had their first and second deliveries in Grampian between 1976 and 2006. Methods All women delivering for the first time between 1976 and 2002 had follow up until 2006 to study their next pregnancy. Those women who had an intrauterine death in their first pregnancy formed the exposed cohort, while those who had a live birth formed the unexposed cohort. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, including pre-eclampsia, placental abruption, induction of labour, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. Results The exposed cohort (n = 364) was at increased risk of pre-eclampsia (OR 3.1, 95% CI 1.7–5.7); placental abruption (OR 9.4, 95% CI 4.5–19.7); induction of labour (OR 3.2, 95% CI 2.4–4.2); instrumental delivery (OR 2.0, 95% CI 1.4–3.0); elective (OR 3.1, 95% CI 2–4.8) and emergency caesarean deliveries (OR 2.1, 95% CI 1.5–3.0); and prematurity (OR 2.8, 95% CI 1.9–4.2), low birthweight (OR 2.8, 95% CI 1.7–4.5) and malpresentation (OR 2.8, 95% CI 2.0–3.9) of the infant as compared with the unexposed cohort (n = 33 715). The adjusted odds ratio for stillbirth was 1.2 and 95% CI 0.4–3.4. Conclusion While the majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a high-risk group with an increased incidence of adverse maternal and neonatal outcomes.

KW - Intrauterine death

KW - obstetric outcome

KW - stillbirth

KW - subsequent pregnancy

U2 - 10.1111/j.1471-0528.2007.01562.x

DO - 10.1111/j.1471-0528.2007.01562.x

M3 - Article

VL - 115

SP - 269

EP - 274

JO - BJOG-An International Journal of Obstetrics and Gynaecology

JF - BJOG-An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 2

ER -