Premium
The epidemiology of antepartum fetal death in Jamaica
Author(s) -
Greenwood Rosemary,
FosterWilliams Karen,
Ashley Deanna,
Keeling Jean,
Golding Jean
Publication year - 1994
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/j.1365-3016.1994.tb00494.x
Subject(s) - medicine , obstetrics , epidemiology , singleton , logistic regression , incidence (geometry) , syphilis , diabetes mellitus , prenatal care , residence , marital status , pediatrics , demography , pregnancy , population , environmental health , human immunodeficiency virus (hiv) , genetics , physics , family medicine , sociology , optics , biology , endocrinology
Summary. All perinatal deaths occurring over a 12‐month period on the island of Jamaica were classified using the Wigglesworth schema. In all, there were 584 antepartum fetal deaths (incidence 10.7 per 1000 total births). Comparison of the 558 singleton deaths with 9919 singleton survivors revealed, using logistic regression, strong associations with union (marital) status, maternal employment status, the composition of the household, the sole use of a toilet by the household, the parish of residence, whether the mother was trying to get pregnant and the mother's age (the older the mother the higher the risk). Independent of these factors were strong statistically significant relationships with syphilis, diabetes, maternal anaemia, third‐trimester bleeding, highest diastolic blood pressure of 90mm or more and highest proteinuria of ++ or more. Mothers who had taken prophylactic iron were at substantially lower risk compared with those who had not. We conclude that appropriate identification and treatment of syphilis, diabetes, anaemia and hypertension give the best chance of reduction of the high antepartum fetal death rate on the island.