■我们旨在描述法属圭亚那西部多种族胎儿宫内死亡的流行病学,并评估其主要原因和危险因素。
■根据2016年1月至2021年12月的数据进行了回顾性描述性研究。提取了法国西部圭亚那医院中心胎龄≥20周的所有死产信息。妊娠终止被排除。我们专注于病史,临床调查,生物学发现,胎盘组织学,尸检以阐明死因.我们使用胎儿死亡的初始原因(INCODE)分类系统进行评估。进行单变量和多变量逻辑回归分析。
■总的来说,对318例死产分娩中的331例胎儿进行了审查,并与同期发生的活产进行了比较。胎儿死亡率在1.3%到2.1%之间,6年期间平均为1.8%。产前护理不良(104/318,32.7%),肥胖≥30kg/m2(88/318,31.7%),子痫前期(59/318,18.5%)是本组胎儿死亡的主要危险因素。报告了四次高血压危机。根据INCODE分类,胎儿死亡的主要原因是产科并发症(112/331,33.8%),尤其是产时胎儿死亡与26周以下的分娩相关窒息(64/112,57.1%),胎盘早剥(29/112,25.9%)。母胎感染很常见,特别是蚊子传播的疾病(例如,寨卡病毒,登革热,和疟疾),重新出现传染性病原体,如梅毒,严重孕产妇感染(8/331,2.4%)。19.3%的胎儿死亡(64/331)仍无法解释。
■生活方式的改变以及社会剥夺和隔离对法属圭亚那西部的怀孕产生不利影响,在类似于亚马逊盆地的不良医疗保健系统的背景下。必须特别注意孕妇和从亚马逊地区返回的旅行者中出现的传染性病原体。
UNASSIGNED: We aimed to describe the epidemiology of intrauterine fetal deaths in multiethnic western French Guiana and to assess its main causes and risk factors.
UNASSIGNED: 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.
UNASSIGNED: 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/m2 (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.
UNASSIGNED: 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.