Risk Factors for Intrauterine Fetal Demise
(IUFD) From 2000-2006
Michael S. McLemore, Department of
Pathology, Albert Einstein College of Medicine/ Montefiore Medical
Center, Bronx, NY
Somnath Pal, Department of Pharmacy
and Administrative Sciences, College of Pharmacy and Allied Health
Professions
Sandra E. Reznik, Department of
Pharmaceutical Sciences, College of Pharmacy and Allied Health
Professions
Abstract: Aim: The aim of the
present study is to evaluate the incidences of various risk factors
for IUFD among autopsy cases and to compare these to the incidences
found among live-birth control deliveries from 2000-2006.
Hypothesis: We hypothesize that
the incidences of diabetes mellitus (DM) and hypertension (HTN) are
significantly greater among IUFDs than live-birth control cases
from 2000-2006.
Design: Reports of IUFD autopsies (n=117) from 2000-2006 were
reviewed and compared to records of live-birth control deliveries
(n=222) randomly selected during this same time interval.
Both the medical records of the neonates and of their mothers were
investigated for IUFD risk factors.
Results: Maternal risk
factors for IUFD made a significant impact on fetal outcome.
The incidence of DM (Gestational or Type II) was significantly
greater among IUFD cases (n=117) than live-birth controls (n=222)
(13.0% v. 6.8%, Fishers Exact, p=0.045). The incidence of HTN
was greater among IUFDs (12.2% v. 5.9%, p=0.037), and the incidence
of advanced maternal age was greater among IUFD cases as well
(23.3% v. 13.1%, p=0.013). Several placental risk factors and
several fetal risk factors were also associated with a higher
incidence of IUFD.
Conclusions: Our live-birth
data has elucidated the significant associations that exist between
IUFD and several maternal, placental and fetal risk factors.
The incidences of diabetes and hypertension are both significantly
greater among IUFD cases than among controls, suggesting that these
factors seriously impact fetal outcome. As the rates of
diabetes and obesity continue to rise in the US, pregnant minority
women are likely to become increasingly vulnerable to these
diseases. Our results can guide healthcare providers in the
provision of tailored prenatal screening and obstetric care for
minority women, and in the development of prenatal programs for
medically underserved regions.