Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies
PLoS Medicine Aug 07, 2019
Muglu J, Rather H, Arroyo-Manzano D, et al. - Through cohort studies on term pregnancies that gave estimates of stillbirths or neonatal deaths by gestation week, researchers carried out a systematic review in order to quantify the risks of stillbirth and neonatal death at term (from 37 weeks gestation) according to gestational age. Thirteen studies (15 million pregnancies, 17,830 stillbirths) were involved in this study. Four, two, five and two studies gave the risks of stillbirth in mothers of the White and Black race, in mothers of White and Asian race, in mothers of the White race only, and in mothers of the Black race only, respectively. The prospective risk of stillbirth progressed with gestational age from 0.11 per 1,000 to 3.18 per 1,000 pregnancies at 37 weeks and at 42 weeks, respectively. For deliveries at 42 vs 41 weeks gestation, neonatal mortality progressed when pregnancies extended beyond 41 weeks and the risk rose markedly. For every 1,449 pregnancies that advanced from 40 to 41 weeks, one additional stillbirth occurrence was noted. Hence, when term pregnancies extended to 41 weeks vs delivery at 40 weeks, an important additional risk of stillbirth, with no corresponding decrease in neonatal mortality was noted.
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