Search PubMed⌕ Search

Biomedical subjects

M Mazor

Publications and source records attributed to M Mazor.

At least 55 records · Page 3Linked to original sources
PubMed2001

Risk factors associated with true knots of the umbilical cord.

OBJECTIVE: To determine obstetrical risk factors and pregnancy outcome of fetuses with true knot of the umbilical cord. METHODS: Study population included 69,139 singleton deliveries occurring between the years 1990-1997. Data were retrieved from the database of the Soroka University Medical Center. Fetuses with malformations were excluded. RESULTS: The incidence of true knots was 1.2% (841/69,139). In a multivariate analysis the following factors were found to be significantly associated with true knot of cord: grandmultiparity, chronic hypertension, hydramnios, patients who undergone genetic amniocentesis, male gender and cord problems (prolapse of cord and cord around the neck). The incidence of fetal distress and meconium stained amniotic fluid was significantly higher among patients with true knots of cord (7% versus 3.6%, P<0.001 and 22% versus 16%, respectively, P<0.0001). Moreover, there was a four-fold higher rate of antepartum fetal death among those fetuses (1.9% versus 0.5%, P<0.0001). In addition, fetuses with true knots of the umbilical cord were more often delivered by a cesarean section (130/841 versus 711/68,298, P<0.0001). The following obstetrical factors were found to be significantly correlated to true knots of the umbilical cord in a multiple logistic regression model: gestational diabetes, hydramnios, patients undergoing genetic amniocentesis, male fetuses. CONCLUSIONS: Patients with hydramnios, who underwent genetic amniocentesis and those carrying male fetuses are at an increased risk for having true knots of the umbilical cord. Thus, careful sonographic and Doppler examinations should be seriously performed in these patients for detection of the complication of the umbilical cord.

Adult↗
PubMed2001

Infertility treatment is an independent risk factor for cesarean section among nulliparous women aged 40 and above.

OBJECTIVE: To determine whether nulliparous women > 40 years old with singleton pregnancies who conceived after infertility treatment are at an increased risk for cesarean section compared with older nulliparous patients who conceived spontaneously. STUDY DESIGN: All subjects in this study were nulliparous women > 40 years old with singleton gestations who were delivered of their infants between 1990 and 1998. The Mantel-Haenszel procedure was used to obtain the weighted odds ratios and to control for confounding variables. RESULTS: During the study period, 115 nulliparous women > 40 years old with singleton pregnancies were delivered of their infants in our institute. Of those, 80 pregnancies were spontaneous and 35 pregnancies occurred after infertility treatment. Women treated for infertility had a higher rate of low-birth-weight (< 2500 g) newborns (34.3% versus 10.1%; odds ratio, 4.7; 95% CI, 1.5 to 14.6; P = .002). No other statistically significant demographic and obstetric differences were found between the groups. There were no cases of perinatal death in the study population. Women treated for infertility had statistically significant higher rates of cesarean section compared with those who conceived spontaneously (71.4% versus 41.3%; odds ratio, 3.6; 95% CI, 1.4 to 9.2; P =.002). Stratified analysis (the Mantel-Haenszel technique) was used to control for possible confounders such as low birth weight, pathologic presentations, failed induction, nonprogressive labor, and nonreassuring fetal heart rate tracings. None of those variables explained the higher incidence of cesarean section in the group treated for infertility. CONCLUSION: A history of infertility treatment among nulliparous women > 40 years old with singleton pregnancies increases the risk for cesarean delivery independently of other known risk factors.

Adult↗
PubMed2001

Abnormal fetal heart rate tracing patterns during the first stage of labor: effect on perinatal outcome.

OBJECTIVE: The purpose of this study was to evaluate perinatal outcomes of infants who had pathologic fetal heart rate tracings during the first stage of labor, in comparison with pregnancies with normal tracings. STUDY DESIGN: The perinatal outcomes of 301 infants born at 37 to 42 weeks of gestation with pathologic fetal heart rate patterns during the first stage of labor were compared with 300 infants with normal fetal heart rate tracing patterns. The data were collected prospectively. Tracings were interpreted with the use of the National Institute of Child Health and Human Development fetal heart rate monitor guidelines. RESULTS: Hydramnios (odds ratio, 7.68; 95% CI, 1.75%-33.63%), oligohydramnios (odds ratio, 2.74; 95% CI, 1.01%-7.39%), and the presence of meconium-stained amniotic fluid (odds ratio, 1.91; 95% CI, 1.03%-3.3%) were independent factors that were associated with pathologic fetal heart rate monitoring during the first stage of labor in a multivariable analysis. The occurrences of umbilical arterial pH of <7.20, a 1-minute Apgar score of <7, a base deficit of 12 mmol/L or higher, and operative deliveries were significantly higher in the study group as compared with subjects with normal fetal heart rate monitoring. Late decelerations and severe variable decelerations (<70 bpm) during the first stage of labor were independent risk factors (odds ratio, 17.5; 95% CI, 1.61%-185.7% and odds ratio, 3.9; 95% CI, 1.36%-11.7%, respectively) that were associated with fetal acidosis (determined by both pH of <7.2 and a base deficit of 12 mmol/L or higher) in a multiple logistic model, controlled for hydramnios, oligohydramnios, meconium-stained amniotic fluid, augmentation by oxytocin, nulliparity, duration of first stage of labor, and birth weight. CONCLUSION: The operative delivery rate was higher among patients with abnormal first-stage fetal heart rate patterns. Late decelerations and severe variable decelerations were significant factors associated with fetal acidosis.

Apgar Score↗
PubMed2001

Lack of prenatal care in two different societies living in the same region and sharing the same medical facilities.

We set out to examine pregnancy outcome of women who utilised prenatal care facilities and those who did not, within two different ethnic groups living in the same region and sharing basically the same medical facilities. The study population consisted of all singleton deliveries occurring between the years 1990-97 (n = 78 955). The analysis was based on a comparison of births to Jewish and Bedouin women who did not have prenatal care (defined as less than three visits at any prenatal care facility during the pregnancy) and those who had prenatal care (at least three visits at any prenatal care facility). Lack of prenatal care was found in 0.98% of the Jewish mothers and in 20.95% of the Bedouin women. Bedouin women receiving prenatal care had significantly higher rates of perinatal mortality (OR = 1.8, 95% CI 1.6-2.2; P < 0.001) and newborns weighing less than 2500 g (OR = 1.2, 95% CI 1.2-1.3; P < 0.001) compared to their Jewish counterparts. However, in the comparison of women lacking prenatal care, no statistically significant differences were found between the groups with regard to those variables. In spite of the overwhelming cultural and socioeconomic differences between these societies, lack of prenatal care crossed social borders and a similar poor pregnancy outcome was found to be common in the two groups. Attempts should be made in order to remove barriers to prenatal care and to increase adequate utilisation of prenatal care in all societies in general and in ethnic minorities in particular.

Journal Article↗
PubMed2001

Evidence for abnormal middle cerebral artery values in patients with idiopathic hydramnios.

OBJECTIVE: Idiopathic hydramnios is an independent risk factor for perinatal morbidity and mortality, although the precise mechanism is unknown. Hydramnios may alter oxygen delivery to the human fetus. The middle cerebral artery (MCA) pulsatility index (PI) is a sensitive parameter for detection of blood flow redistribution or centralization. The aim of this study was to determine whether idiopathic hydramnios is associated with changes in the PI of the MCA and the umbilical artery (UA). DESIGN: The PI of the MCA and UA were determined prospectively in 113 consecutive pregnant women with singleton pregnancies and idiopathic hydramnios (study group) and in 113 matched control patients with normal amniotic fluid (AF) volume (control group). The control group was matched for maternal age, gravidity, parity and gestational age at examination. Hydramnios was defined as an AF index above 24 cm. Patients with fetal structural or chromosomal anomalies and with diabetes mellitus were excluded. A PI below the 5th centile for the MCA was considered abnormal. RESULTS: The rate of abnormal MCA PI was significantly higher in the study group than in the control group (30.9% (35/113) vs. 5.3% (6/113), respectively, OR 8.0; p < 0.0001; 95% CI 3.3-22.1). A significant inverse correlation was found between MCA PI and increasing AF index among patients with hydramnios (p = 0.008, r = 0.46). In contrast, there were no significant differences between the UA PI (0.93 (0.57-2.06) vs. 1.0 (0.49-1.48), (p = 0.20)) and MCA/UA (1.86 (0.77-2.01) vs. 2.15 (0.86-4.11), (p = 0.14)) in both groups. CONCLUSIONS: Our observations provide evidence of cerebral blood flow redistribution in fetuses with idiopathic hydramnios.

Adult↗
PubMed2001

Placenta previa: obstetric risk factors and pregnancy outcome.

OBJECTIVE: To determine the incidence, obstetric risk factors and perinatal outcome of placenta previa. STUDY DESIGN: All singleton deliveries at our institution between 1990 and 1998 complicated with placenta previa were compared with those without placenta previa. RESULTS: Placenta previa complicated 0.38% (n = 298) of all singleton deliveries (n = 78 524). A back-step multiple logistic regression model found the following factors to be independently correlated with the occurrence of placenta previa: maternal age above 40 years (OR 3.1, 95% CI 2.0-4.9), infertility treatments (OR 3.1, 95% CI 1.8-5.6), a previous Cesarean section (OR 1.8, 95% CI 1.4-2.4), a history of habitual abortions (OR 1.3, 95% CI 1.3-2.7) and Jewish ethnicity (OR 1.3, 95% CI 1.1-1.8). Pregnancies complicated with placenta previa had significantly higher rates of second-trimester bleeding (OR 156.0, 95% CI 87.2-277.5), pathological presentations (OR 7.6, 95% CI 5.7-10.1), abruptio placentae (OR 13.1, 95% CI 8.2-20.7), congenital malformations (OR 2.6, 95% CI 1.5-4.2), perinatal mortality (OR 2.6, 95% CI 1.1-5.6), Cesarean delivery (OR 57.4, 95% CI 40.7-81.4), Apgar scores at 5 min lower than 7 (OR 4.4, 95% CI 2.3-8.3), placenta accreta (OR 3.6, 95% CI 1.1-9.9) postpartum hemorrhage (OR 3.8, 95% CI 1.2-10.5), postpartum anemia (OR 5.5, 95% CI 4.4-6.9) and delayed maternal and infant discharge from the hospital (OR 10.9, 95% CI 7.3-16.1) as compared to pregnancies without placenta previa. In a multivariable analysis investigating risk factors for perinatal mortality, the following were found to be independent significant factors: congenital malformations, placental abruption, pathological presentations and preterm delivery. In contrast, placenta previa and Cesarean section were found to be protective factors against the occurrence of perinatal mortality while controlling for confounders. CONCLUSION: Although an abnormal implantation per se was not an independent risk factor for perinatal mortality, placenta previa should be considered as a marker for possible obstetric complications. Hence, the detection of placenta previa should encourage a careful evaluation with timely delivery in order to reduce the associated maternal and perinatal complications.

Abortion, Habitual↗
PubMed2001

Preterm premature rupture of membranes is not an independent risk factor for neonatal morbidity.

OBJECTIVE: To evaluate the risk factors for development of neonatal morbidity in cases of preterm premature rupture of membranes (PPROM). METHODS: The study population consisted of 2326 singleton preterm births occurring between 1994 and 1997 at Soroka University Medical Center. The neonatal morbidity included respiratory distress syndrome, intraventricular hemorrhage (grade III-IV), necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia, neonatal pneumonia and sepsis. A cross-sectional study was designed to compare neonatal morbidity between two groups: the study group consisted of patients with PPROM (n = 376) and the comparison group of patients without PPROM (n = 1950). RESULTS: The prevalence of the neonatal morbidity associated with PPROM was 13.0% (49/376). There was no statistically significant difference in neonatal morbidity rates between the PPROM group and the group with intact membranes in any of the birth-weight groups (Mantel-Haenszel weighted odds ratio 1.20; 95% CI 0.80-1.20), or gestational-age groups (Mantel-Haenszel weighted odds ratio 1.03; 95% CI 0.79-1.55). There was no statistically significant difference in neonatal morbidity between patients with PPROM and those with intact membranes according to clinical chorioamnionitis. Congenital anomalies did not influence the neonatal morbidity when comparing patients with and without PPROM (44.4% vs. 32.8%, respectively; p = 0.23). CONCLUSIONS: PPROM was not an independent risk factor for neonatal morbidity in preterm births. Neonatal morbidity was affected mainly by prematurity itself, rather than by the occurrence of PPROM.

Adult↗
PubMed2001

Fetal serum levels of insulin, growth hormone and insulin-like growth factor-I in concordant and discordant twin gestations.

OBJECTIVE: To examine the role of insulin, growth hormone and insulin-like growth factor (IGF)-I in concordant and discordant twin pairs. METHODS: Umbilical cord serum samples were obtained from 20 twin pairs with weight discordancy (intertwin birth weight difference > 20%) and from 20 concordant twins (intertwin birth weight difference < 20%), both groups of similar gestational age, gravidity, and parity. The serum samples were analyzed for the levels of IGF-I, growth hormone and insulin in both maternal and fetal compartments. RESULTS: Among the group of discordant twins, the normally grown twin, in all cases, had significantly higher cord serum IGF-I levels than their growth-restricted co-twin (108 +/- 73 ng/ml vs. 39 +/- 24 ng/ml; p < 0.01). There were no significant intertwin differences in the cord blood IGF-I levels in the concordant twin pairs (87 +/- 44 vs. 88 +/- 48 ng/ml; p = 0.986). Insulin and growth hormone levels did not correlate with intertwin birth weight differences. CONCLUSION: These data demonstrate that IGF-I is important in the regulation of both normal and restricted fetal growth in utero, and its action appears to be, at least in part, through an endocrine action. The precise role of growth hormone and insulin in fetal growth restriction remains uncertain.

Female↗
PubMed2001

Oxytocin use in grand-multiparous patients: safety and complications.

OBJECTIVE: To determine whether the use of oxytocin for the augmentation of labor in grandmultiparous women increases the risk of peripartum complications. STUDY DESIGN: During the years 1989-97, 11 075 grand-multiparous women delivered at our institution. In 424 grand-multiparous women, intravenous oxytocin was used for augmentation of labor. The control group consisted of the other 10 651 grand-multiparous women. All women were monitored for fetal heart rate and uterine contractions. We compared the rates of maternal and perinatal complications in these two groups by using chi(2) analysis and Fisher's exact test when appropriate. RESULTS: No significant differences were found between the oxytocin and the control groups in the rates of placental abruption, intrapartum fetal death, postpartum hemorrhage, uterine rupture, fetal distress, meconium-stained amniotic fluid, an Apgar score of less than 7 at 5 min, Cesarean section, retained placenta and vaginal and cervical lacerations. In contrast, a significant increase in the rate of vacuum deliveries was observed in patients given oxytocin as compared to controls (3.5% vs. 1.4%, respectively; p = 0.001). CONCLUSIONS: The use of oxytocin in the grand-multiparous parturient was a safe procedure with no significant increase in peripartum complications. However, a higher rate of vacuum deliveries was found.

Adult↗
PubMed2001

Immunohistochemical staining of IL-1 alpha and IL-1 receptor antagonist but not IL-1 beta in cultures of sertoli cells.

The interleukin-1 (IL-1) system has been suggested to be involved in the cell cell cross talk within the testis. To identify a testicular cell source of IL-1 alpha, IL-1 beta and IL-1 receptor antagonist (IL-1ra), immature mouse Sertoli cells were isolated, purified, cultured and examined for the cellular compartment localization of these cytokines by immunohistochemical staining. Our results show that both Germ cells and Sertoli cells in unpurified Sertoli cell cultures (before hypotonic shock) and purified culture of Sertoli cells (after hypotonic shock) were stained for IL-1 alpha. The levels of this cytokine were increased in Sertoli cells when the purified cultures were stimulated with lipopolysaccharide (LPS) (5 microg/mL). However, we could not identify a positive staining for IL-1 beta when Sertoli cell cultures were stained for this cytokine, even after stimulation with various concentrations of LPS (0.1-10 microg/mL). On the other hand, immunohistochemical staining of isolated Sertoli cells without treatment with hypotonic shock (cultures containing Sertoli cells and Germ cells) for IL-1ra showed constitutive positive staining of both cell types (Sertoli cells and Germ cells). Our results, using immunohistochemical staining, may indicate the different expression of IL-1 alpha, IL-1 beta and IL-1ra in Sertoli cells. These results may suggest the involvement of IL-1 system in the autocrine and paracrine regulation of testicular cell functions.

Animals↗
PubMed2001

A role for the 72 kDa gelatinase (MMP-2) and its inhibitor (TIMP-2) in human parturition, premature rupture of membranes and intraamniotic infection.

OBJECTIVE: Degradation of the extracellular matrix in fetal membranes has been implicated in the process of parturition and rupture of membranes. Matrix metalloproteinases (MMPs) are enzymes capable of degrading extracellular matrix including collagen. Tissue inhibitors of matrix metalloproteinases (TIMPs) inhibit the activity of MMPs by covalently binding to the enzymes. MMP-2 degrades Type IV collagen and TIMP-2 is its specific inhibitor. The objective of this study was to determine if human parturition, rupture of membranes (term and preterm) and microbial invasion of the amniotic cavity (MIAC) are associated with changes in the concentrations of MMP-2 and TIMP-2 in amniotic fluid. STUDY DESIGN: A cross-sectional study was conducted with women in the following categories: 1) term with intact membranes, in labor and not in labor; 2) preterm labor and intact membranes who delivered at term, who delivered preterm and preterm labor with MIAC; 3) preterm premature rupture of membranes (PROM) with and without infection; 4) term and preterm PROM not in labor; and 5) midtrimester. MMP-2 and TIMP-2 concentrations in amniotic fluid were determined using sensitive and specific immunoassays. RESULTS: The concentration of TIMP-2 increased with advancing gestational age (r = 0.6, p < 0.001). No correlation was found between MMP-2 concentrations and gestational age. Human parturition and rupture of membranes (term and preterm) and in patients with intact membranes were not associated with changes in the amniotic fluid MMP-2 concentrations. In contrast, 1) patients with spontaneous labor (term and preterm) had significantly lower median concentrations of TIMP-2 compared to those not in labor (p < 0.05 for both); 2) MIAC in women with preterm labor and preterm PROM was associated with a significant decrease in amniotic fluid TIMP-2 concentrations (p < 0.04 for both comparisons); 3) Rupture of the membranes (term and preterm) was also associated with a significant decrease in the amniotic fluid TIMP-2 concentrations (p < 0.05 and p < 0.03, respectively). CONCLUSIONS: Human parturition (preterm and term), rupture of fetal membranes (term and preterm) and intraamniotic infection are associated with a significant decrease in amniotic fluid TIMP-2 concentrations.

Amniotic Fluid↗
PubMed2001

Albumin-dependent digoxin transfer in isolated perfused human placenta.

OBJECTIVE: To determine the effects of albumin (BSA) concentration in perfusion medium on digoxin transfer in isolated perfused human placental cotyledon. STUDY DESIGN: Isolated placental cotyledons from 13 normal human placentas were dually perfused after cannulating artery and vein of the chorionic plate and piercing 4 catheters through the corresponding basal plate with M199 medium enriched with BSA and glucose. Flow rates were 12 and 6 ml/min in the maternal and fetal circuits, respectively. Digoxin was added to the maternal reservoir at a final concentration of 5.51 +/- 1.00 ng/ml. BSA in maternal and fetal perfusate was kept at 3 concentrations: 1, 3 and 5 mg/ml (Groups I, II, III). Transplacental passage of digoxin was calculated from repeated fetal and maternal perfusate samples collected over 3 hours in the 3 groups. Digoxin levels were measured by FPIA (TDx, Abbott). RESULTS: There was no transfer of digoxin from the maternal to fetal compartment when the concentration of BSA was 1 mg/ml. Increasing the concentration of BSA led to a substantial increase in the transfer of digoxin to the fetal compartment. Steady state levels of digoxin in the fetal compartment were 0.61 +/- 0.19 ng/ml at 3 mg/ml of BSA. CONCLUSION: Maternal and fetal serum concentration of BSA affect digoxin transfer in isolated perfused human placentas. Three mg/ml are considered to be the optimal albumin concentration.

Analysis of Variance↗
PubMed2001

Fetal death associated with asymptomatic intrauterine Candida albicans infection and a retained intrauterine contraceptive device.

We present a case of intrauterine fetal death at 18 weeks of gestation associated with a retained intrauterine contraceptive device and asymptomatic intraamniotic and fetal infection by Candida albicans. The infection was verified by histopathologic examination of the placenta and umbilical cord, growth of C. albicans in samples of amniotic fluid and the presence of high levels of IL-6 in the amniotic fluid.

Adult↗
PubMed2001

Lack of prenatal care in a traditional society. Is it an obstetric hazard?

OBJECTIVE: To examine the association between lack of prenatal care (fewer than three visits at any prenatal care facility) and perinatal complications in the Bedouin parturient population where lack of prenatal care is not associated with absence of prenatal services, substance abuse or marital status. STUDY DESIGN: The study population consisted of all Bedouin women lacking prenatal care (n = 7,601) who gave birth between the years 1990-1997 in the Soroka University Medical Center. The analysis consisted of a comparison of labor and delivery outcomes in women without prenatal care to outcomes in women who had some prenatal care. RESULTS: During the years 1990-1997 there were 36,281 singleton deliveries to Bedouin women at our institution. Of those, 20.9% did not receive prenatal care. Mothers in the no-prenatal-care group tended to be in the extremes of their reproductive cycles (< 18 years, > 35 years) and were of higher parity (P < .001) than those receiving prenatal care. There were more deliveries prior to 32 weeks of gestation in the no-prenatal-care group (2.8%) in comparison to the prenatal care group (1.5%, P < .001) and fewer postterm deliveries (> 42 weeks, P < .01). The incidence of low birth weight (< 2,500 g) in the no-prenatal-care group was higher than in the prenatal-care group (11.2% vs. 8.4%, P < .001). Women who did not receive adequate prenatal care had statistically significantly higher rates of antepartum fetal death (OR = 1.8, 95% CI 1.4-2.3, P < .001), intrapartum fetal death (OR = 2.38, 95% CI 1.2-4.5, P < .03) and postpartum fetal death (OR = 1.60, 95% CI 1.2-2.1, P < .001). Multiple logistic regression models were used to analyze the independent contribution of lack of prenatal care to perinatal mortality and to very-low-birth-weight newborns. In both models lack of prenatal care was an independent contributing factor. CONCLUSION: Lack of prenatal care is an independent contributor to perinatal mortality and low birth weight in a traditional society. In light of the high percentage of lack of prenatal care in Bedouin society, special attempts should be made to encourage women to use the available prenatal services.

Adolescent↗
PubMed2001

Failed vacuum extraction. Maternal risk factors and pregnancy outcome.

OBJECTIVE: To evaluate obstetric risk factors associated with a failed trial of vacuum extraction and to assess its pregnancy outcome. STUDY DESIGN: All attempted vacuum extractions between the years 1990 and 1998 were identified, and a comparison of successful and failed trials of vacuum extraction in singleton, vertex deliveries was performed. RESULTS: Of 2,111 trials of vacuum extraction, 113 (5.4%) cases were complicated by failed extraction and underwent cesarean section. Those neonates were significantly more likely to be large for gestational age, specifically to weigh > 4,000 g as compared to the controls. Patients lacking prenatal care had significantly higher rates of failed vacuum extraction trials. While cervical and uterine tears were rather rare, parturients who had failed trials of vacuum extraction had significantly higher rates of cervical and uterine tears as compared to those with successful vacuum extractions. This association remained significant after controlling for a previous cesarean section using the Mantel-Hanszel technique. Women from the failed vacuum extraction group had significantly higher rates of postpartum anemia. Pregnancies complicated by failed vacuum extraction had significantly higher rates of intrapartum and postpartum fetal death. Those neonates had significantly higher rates of Apgar scores < 7 at one and five minutes. CONCLUSION: Failed trial of vacuum extraction is associated with adverse maternal and fetal outcomes. Risk factors associated with such failures are fetal weight and lack of prenatal care. Thus, careful estimation of fetal weight should be performed before the procedure, and estimated fetal weight > 4,000 g might be considered a relative contraindication to vacuum extraction, especially among patients who did not have prenatal care.

Adolescent↗
PubMed2001

Risk factors for antepartum fetal death.

OBJECTIVE: To determine the demographic, maternal, pregnancy-related and fetal risk factors for antepartum fetal death (APFD). STUDY DESIGN: From our perinatal database between the years 1990 and 1997, 68,870 singleton birth files were analyzed. Fetuses weighing < 1,000 g at birth and those with structural malformations and/or known chromosomal anomalies were excluded from the study. In order to determine independent factors contributing to APFD, a multiple logistic regression model was constructed. RESULTS: During the study period there were 246 cases of APFD (3.6 per 1,000 births). The following obstetric factors significantly correlated with APFD in a multiple logistic regression model: preterm deliveries: small size for gestational age (SGA), multiparity (> 5 deliveries), oligohydramnios, placental abruption, umbilical cord complications (cord around the neck and true knot of cord), pathologic presentations (nonvertex) and meconium-stained amniotic fluid. APFD was not significantly associated with advanced maternal age. CONCLUSION: APFD was significantly associated with several risk factors. Placental and umbilical cord pathologies might be the direct cause of death. Grand multiparity, oligohydramnios, meconium-stained amniotic fluid, pathologic presentations and suspected SGA should be carefully evaluated during pregnancy in order to decrease the incidence of APFD.

Adult↗