Abstract
ABSTRACT Background: Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Objective: This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Methods: The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006–2011 (n = 52,806). We excluded multiple births, births prior to 22 and after 45 completed weeks of gestation, infants with congenital malformations, and births with missing information regarding gestational age (a total of n = 3,666) and/or the studied characteristics (n = 2,356). Possible associations between maternal socio-demographic and lifestyle characteristics, maternal pre-pregnancy characteristics, pregnancy characteristics, and PM were studied by multivariable logistic regression. Crude and adjusted odds ratios with 95% confidence intervals were calculated. Results: Of the 49,140 births eligible for prevalence analysis, 338 were identified as perinatal deaths (6.9 per 1,000 births). After adjustment for other factors, maternal low education level, prior preterm delivery, spontaneous or induced abortions, antepartum hemorrhage, antenatally detected or suspected fetal growth retardation, and alcohol abuse during pregnancy all significantly increased the risk of PM. We observed a higher risk of PM in unmarried women, as well as overweight or obese mothers. Maternal underweight reduced the risk of PM. Conclusions: Our results suggest that both social and medical factors are important correlates of perinatal mortality in Northwest Russia.
Highlights
Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear
The distribution of PM in infants born at Gestational age (GA) 28–31, 32–36, 37–41, and 42+ weeks was 4.7, 21.6, 33.4, and 3.6%, respectively
We found that maternal education was an independent predictor of PM, which agrees with our earlier study in Northwest Russia [8]
Summary
This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Before 2012, PM in Russia was defined as death from 28 completed weeks of gestation to 7 completed days after delivery By this definition, PM in Russia has gradually decreased from 17.9 per 1,000 births in 1990 to 7.4 per 1,000 births in 2010 [3]. In 2012, Russia adopted the World Health Organization (WHO) definition of PM; that is, the number of deaths of fetuses weighing ≥ 500 g (or born at 22 completed weeks of gestation with unknown birthweight [BW]) and newborns up to 7 completed days after delivery, per 1,000 births [5]. Available data exhibit a downward trend in PM in Murmansk County with a decrease from 8.8 [6] to 6.3 [7] per 1,000 births in 2005 and 2011, respectively
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