Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016-2021

被引:3
作者
Mathieu, Meredith [1 ]
Lambert, Veronique [1 ]
Carles, Gabriel [1 ]
Picone, Olivier [2 ,9 ,10 ,11 ,12 ]
Carod, Jean-Francois [3 ]
Pomar, Leo [4 ,5 ,6 ]
Nacher, Mathieu [7 ,8 ]
Hcini, Najeh [1 ,8 ]
机构
[1] West French Guiana Hosp Ctr, Dept Obstet & Gynaecol, St Laurent Du Maroni 97320, French Guiana
[2] Hop Louis Mourier, AP HP, Serv Gynecol Obstet, Colombes, France
[3] West French Guiana Hosp Ctr, Dept Biol, St Laurent Du Maroni, French Guiana
[4] HES SO Univ Appl Sci & Arts Western Switzerland, Sch Hlth Sci HESAV, CH-1011 Lausanne, Switzerland
[5] Lausanne Univ Hosp, Dept Woman Mother Child, Ultrasound & Fetal Med, Lausanne, Switzerland
[6] Lausanne Univ, CH-1011 Lausanne, Switzerland
[7] Ctr Hosp Cayenne, Cayenne, French Guiana
[8] Univ Guyane, DFR Sante, CIC Inserm 1424, Cayenne, French Guiana
[9] Univ Paris, Paris, France
[10] Inserm IAME U1137, Paris, France
[11] Grp Rech Infect Pendant Grossesse GRIG, Velizy Villacoublay, France
[12] FHU Prema, Paris, France
来源
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY-X | 2023年 / 18卷
关键词
Stillbirth etiology; Intrauterine death; Fetal death; Infection; Amazon basin; French Guiana; FRENCH-GUIANA; PREGNANCY; INFECTION; WOMEN;
D O I
10.1016/j.eurox.2023.100190
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: We aimed to describe the epidemiology of intrauterine fetal deaths in multiethnic western French Guiana and to assess its main causes and risk factors. Study design: A retrospective descriptive study was conducted based on data from January 2016 to December 2021. All information on stillbirth with a gestational age >= 20 weeks in the Western French Guiana Hospital Center was extracted. Terminations of pregnancy were excluded. We focused on medical history, clinical investigation, biological findings, placental histology, and autopsy examination to elucidate the cause of death. We used the Initial Cause of Fetal Death (INCODE) classification system for assessment. Univariable and multivariable logistic regression analyses were performed. Results: Overall, 331 fetuses in 318 stillbirth deliveries were reviewed and compared to live births that occurred during the same period. The rate of fetal death varied between 1.3 % and 2.1 %, with an average of 1.8 % over the 6-year period. Poor antenatal care (104/318, 32.7 %), obesity >= 30 kg/m(2) (88/318, 31.7 %), and preeclampsia (59/318, 18.5 %) were the main risk factors associated with fetal death in this group. Four hypertensive crises were reported. According to the INCODE classification, the main causes of fetal death were obstetric complications (112/331, 33.8 %), particularly intrapartum fetal death with labor-associated asphyxia under 26 weeks (64/112, 57.1 %), and placental abruption (29/112, 25.9 %). Maternal-fetal infections were common, particularly mosquito-borne diseases (e.g., Zika virus, dengue, and malaria), re-emerging infectious agents such as syphilis, and severe maternal infections (8/331, 2.4 %). 19.3 % of fetal deaths (64/331) remained unexplained. Conclusion: Change in lifestyle as well as social deprivation and isolation adversely affect pregnancy in western French Guiana, in the context of a poor health care system that is similar to what is found in the Amazonian basin. Particular attention must be paid to emerging infectious agents in pregnant women and travelers returning from the Amazon region.
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页数:6
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