Lack of prenatal care: an independent risk factor for perinatal mortality among macrosomic newborns

Dickstein, Yaakov; Ohel, Iris; Levy, Amalia; Holcberg, Gershon; Sheiner, Eyal
June 2008
Archives of Gynecology & Obstetrics;Jun2008, Vol. 277 Issue 6, p511
Academic Journal
To examine the association between lack of prenatal care (LOPC) and perinatal complications among parturients carrying macrosomic fetuses. The study population consisted of consecutive women with singleton fetuses weighing 4 kg and above, delivered between the years 1988 and 2003. A comparison was performed between parturients lacking prenatal care (fewer than three visits at any prenatal care facility) and those with three and more prenatal care visits. A multiple logistic regression model was constructed in order to investigate the association between LOPC and perinatal mortality. During the study period, 7,332 women delivered macrosomic newborns in our institute. Of those, 8.0% ( n = 590) lacked prenatal care. Patients lacking prenatal care were more likely to be Bedouins, of higher parity and older than the comparison group. Higher rates of perinatal mortality were noted among patients lacking prenatal care (OR = 5.4, 95%CI 2.8–10.5; P < 0.001). Using a multivariable analysis and controlling for macrosomia-related complications, it was found that the association between LOPC and perinatal mortality persisted (OR = 4.1, 95% CI 2.1–8.1; P < 0.001). Lack of prenatal care is an independent risk factor for perinatal mortality among macrosomic newborns.


Related Articles

  • Evaluating perinatal morality rates: effects of referral and case mix. Clarke, Michael; Mason, Elizabeth S.; MacVicar, John; Clayton, David G. // BMJ: British Medical Journal (International Edition);3/27/93, Vol. 306 Issue 6881, p824 

    Examines the perinatal mortality rates as a method of auditing obstetric and neonatal care in Leicestershire, England. Effects of transfer between hospitals during pregnancy and case mix; Differences between general practitioner and consultant units during pregnancy; Adjustment of mortality...

  • Shoulder dystocia: a comparison of patients with and without diabetes mellitus. Levy, Amalia; Sheiner, Eyal; Hammel, Rachel; Hershkovitz, Reli; Hallak, Mordechai; Katz, Miriam; Mazor, Moshe // Archives of Gynecology & Obstetrics;Jan2006, Vol. 273 Issue 4, p203 

    Background: The study was aimed to compare pregnancies complicated with shoulder dystocia, of patients with and without diabetes mellitus. Methods: A comparison of all singleton, vertex, term deliveries between the years 1988–1999, complicated with shoulder dystocia with and without...

  • Perinatal mortality: a sporadic event or a recurrent catastrophe? Weintraub, Adi Y.; Rozen, Amit; Sheiner, Eyal; Levy, Amalia; Press, Fernanda; Wiznitzer, Arnon // Archives of Gynecology & Obstetrics;Mar2009, Vol. 279 Issue 3, p299 

    The purpose of this study was to determine whether women who experienced perinatal mortality in their first delivery had, in their subsequent birth, a higher risk for adverse perinatal outcome. A population-based study was undertaken to compare all second deliveries of women with previous...

  • Utility of local health registers in measuring perinatal mortality: A case study in rural Indonesia. Burke, Leona; Suswardany, Dwi Linna; Michener, Keryl; Mazurki, Setiawaty; Adair, Timothy; Elmiyati, Catur; Rao, Chalapati // BMC Pregnancy & Childbirth;2011, Vol. 11 Issue 1, p20 

    Background: Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan...

  • Cord prolapse audit: recognition, management and outcome. Rogers, Cathy; Schiavone, Nada // British Journal of Midwifery;May2008, Vol. 16 Issue 5, p315 

    Cord prolapse is a rare obstetric emergency associated with increased risks of perinatal mortality. Given the rarity of this complication and associated perinatal mortality and morbidity, multi-disciplinary skills and drills are promoted as a means to ensure that all staff are appropriately...

  • Mother and newborn survival according to point of entry and type of human resources in a maternal referral system in Kayes (Mali). Dogba, Maman; Fournier, Pierre; Dumont, Alexandre; Zunzunegui, Maria-Victoria; Tourigny, Caroline; Berthe-Cisse, Safoura // Reproductive Health;2011, Vol. 8 Issue 1, p13 

    Background: Since 2001, a referral system has been operating in Kayes (Mali) to reduce maternal and perinatal deaths. Normal deliveries are managed in community health centers (CHC). Complicated cases are referred to a district health center (DHC) or the regional hospital (RH). Women with...

  • Perinatal Mortality During Fifteen-year Period in Tuzla Canton, Bosnia and Herzegovina. Fatusic, Jasenko; Hudic, Igor; Fatusic, Zlatan // Medicinski Arhiv;2012, Vol. 66 Issue 4, p258 

    The aim was to determine the incidence of perinatal mortality, as well as the frequency of premature deliveries. Methods: We analyzed the data of birth protocol at the Clinics for Gynecology and Obstetrition at the University Clinical Centre in Tuzla in period 1992-2006. Results: Perinatal...

  • Birth order, gestational age, and risk of delivery related perinatal death in twins: retrospective cohort study. Smith, Gordon C S; Pell, Jill P; Dobbie, Richard // BMJ: British Medical Journal (International Edition);11/2/2002, Vol. 325 Issue 7371, p1004 

    Abstract Objective: To determine whether twins born second are at increased risk of perinatal death because of complications during labour and delivery. Design: Retrospective cohort study. Setting: Scotland, 1992 and 1997. Participants: All twin births at or after 24 weeks' gestation, excluding...

  • Risks of stillbirth and early neonatal death by day of week.  // CMAJ: Canadian Medical Association Journal;2/3/2004, Vol. 170 Issue 3, p337 

    Background: Higher risks of stillbirth or early neonatal death, or both, have been reported from several countries for births on weekend days. It is unclear whether such higher risks have persisted in recent years. We investigated weekend-associated risks of stillbirth and early neonatal death...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics