[Perinatal risk factors for the occurrence of singleton apparently stillborn infants].

Objectives: To identify the perinatal risk factors for the occurrence of singleton apparently stillborn infants.

Methods: This was a case-control study. A total of 154 singleton neonates with gestational age ≥28 weeks and Apgar score of 0-1 who were subsequently successfully resuscitated in the Obstetrics and Gynecology Hospital of Fudan University from January 2006 to December 2015 were enrolled as the case group (apparently stillborn group). A total of 616 singleton infants born from January 2006 to December 2015 (1-minute Apgar score >1) were randomly selected in a 1:4 ratio as the control group. Univariate analysis and multivariate logistic regression were used to analyze the perinatal risk factors for the occurrence of apparently stillborn infants.

Results: The gestational age and birth weight in the apparently stillborn group were significantly lower than those in the control group (<0.05). The incidences of fetal hydrops, cord prolapse, grade III meconium-stained amniotic fluid, placental abruption, breech presentation, severe pre-eclampsia, maternal general anesthesia at delivery, abnormal antenatal fetal heart monitoring and decreased fetal movement were significantly higher in the apparently stillborn group than those in the control group (<0.05). The multivariate logistic analysis showed that the mother had general anesthesia at delivery (=34.520), decreased antenatal fetal movement (=28.168),placental abruption (=15.641), grade III meconium-stained amniotic fluid (=6.365), abnormal antenatal fetal heart monitoring (=5.739), and breech presentation (=2.614) were risk factors for the occurrence of apparently stillborn infants (<0.05), while higher gestational age was a protective factor (=0.686, <0.05).

Conclusions: Attention needs to be paid to mothers with abnormal prenatal fetal heart monitoring, decreased fetal movement, preterm labor, placental abruption, breech presentation, grade III meconium-stained amniotic fluid, and general anesthesia. Preparations for resuscitation should be done to rescue apparently stillborn infants.