Abstract
Background: Number of fetal deaths reflects the quality and accessibility of the health care provided to pregnant, as well as the quality of intrapartum care. Objective of this study was to evaluate the association between delays in the care provided to pregnant and the outcomes of fetal death in a maternity. Methods: Observational, case-control study, including 72 cases of fetal death and 144 controls (born alive) performed at the Obstetrics Service of Maternidade Assis Chateaubriand Maternity Hospital, Fortaleza, Ceara. Controls were matched (2:1) by the approximate gestational age of the case. The groups were compared using the three obstetric care delays model. Pearson's chi-square test and Fisher's exact test were used to compare the groups. P <0*05 was considered statistically significant. Findings: Group with fetal death had a smaller number of prenatal consultations (> 6 consultations: 27*8% in cases, 40*3% in controls, p = 0*003), less risk classification of pregnancy (41*7% vs 55*9%, p = 0*048), less guidance about the location of birth (44*5% vs 64%, p = 0*009), lower frequency of cesarean sections (25*4% vs 65*7%) and higher prevalence of hemorrhagic syndromes (33*3% vs 19*4%, p = 0*024) and syphilis (15*3% vs 4*2%, p = 0*004). In logistic regression, variables that persisted significantly associated with fetal death were: Refusal of Assistance (OR = 4*07, IC 95%: 1*08-15*3), Absence or inadequacy of prenatal care (OR = 2*69, IC 95%: 1*07- 6*75), Delay in diagnosis (OR = 10*3, IC 95%: 2*58-41*4) and Inadequate patient conduct (OR = 4*88; IC 95%: 1*43-16*6). Interpretation: Despite having a higher prevalence of obstetric complications, gestations with fetal death have more delays in obstetric care. Funding: None. Declaration of Interest: There is no conflict of interest. Ethical Approval: The study was approved by the research ethics committee of the Federal University of Ceara with protocol number: 2.144.962
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