Perinatal death and neurological damage as a sequential chain of poor outcome

Abstract

Objective: We investigated the risk factors of perinatal death and neurological damage. Methods: Perinatal death and neurological damage were retrospectively investigated using a population-based study of 108 024 deliveries from 1998 to 2007. Main factors studied were asphyxia, growth restriction and preterm delivery < 34 weeks of gestation, since these three factors were most often associated with poor prognosis. The impact of each factor was identified by multiple regression analyses. Results: There were 459 perinatal deaths (4.3/1000) and 220 neurological damages (2.0/1000). Preterm delivery accounted for 50% of perinatal deaths and neurological damage, whereas it constituted 2.6% of total births. Multiple regression analyses showed that prematurity < 34 weeks (10-fold), asphyxia (10-fold) and growth restriction (2-fold) were independent and significant risk factors associated with poor outcomes, and that the magnitude was similar throughout the three consecutive critical events of fetal death, neonatal death and neurological damage. Conclusions: Prematurity < 34 weeks, asphyxia and growth restriction are independent and persistent risk factors from perinatal death to neurological damage.

Keywords::

• asphyxia
• growth restriction
• population-based study
• prematurity

Acknowledgement

This study was partly supported by a grant # 79-258 from The Ministry of Education, Culture, Sports, Science, and Technology of Japan.

Declaration of interest: The authors report no declaration of interest.