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  • Title: Perinatal mortality in Taiwan.
    Author: Wang PD, Lin RS.
    Journal: Public Health; 1999 Jan; 113(1):27-33. PubMed ID: 10823745.
    Abstract:
    Information on perinatal deaths was obtained from 310 women by collecting detailed obstetric histories dating from marriage to the start of the survey. These histories were compared to those of 688 age matched controls. Potential risk factors, levels and time trends of perinatal mortality in Taiwan were examined and factors underlying stillbirths and early neonatal deaths were also compared using conditional logistic regression analyses. A nearly 56% decline of the perinatal mortality rate during the 35 y, approximately, prior to the survey was observed. Risk of stillbirths was increased among those who had abused illegal drugs during pregnancy, those who reported that the pregnancy was unwanted and those with Thalassemia trait. Body mass index was log-linearly related with stillbirths, with higher body mass associated with higher risk. For early neonatal deaths, those mothers aged 19 y or less, those giving birth to either their first children or to their fifth or later child, those who had their first prenatal care visit after the first three months of pregnancy were associated with increased risk in the logistic model. Those with a birth interval of less than two years and those with less education were associated with increased risk in both perinatal death groups. While some of these factors have already been associated with perinatal deaths, others have not; the new associations provide clues to mechanisms by which the risk of death increases before or after delivery. Each year in Taiwan, there are approximately 320,000 live births and more than 6400 deaths during the perinatal period. In many cases, the cause of death is unknown. To determine whether there are subgroups of the Taiwanese population which are at increased risk of perinatal death and to attempt to provide appropriate preventive measures, the authors conducted a randomized case-control study to compare the similarities and differences in the underlying causes of stillbirths and neonatal deaths. Findings are based upon data obtained for women attending family planning services in Taipei between July 1991 and December 1992. Data on perinatal mortality were obtained from 310 women by collecting detailed obstetric histories dating from marriage to the start of the survey. Those histories were then compared to those of 688 age-matched controls. Potential risk factors, levels, and time trends of perinatal mortality in Taiwan were examined, and factors underlying stillbirths and early neonatal deaths compared using conditional logistic regression analyses. When all perinatal deaths were considered, maternal age of 19 years or less, birth interval of less than 2 years, maternal attitude toward unwanted pregnancy, being a mother with Thalassemia trait, and high body mass all appeared to increase the risk of perinatal mortality. Illegal drug use during pregnancy was suggestive of increased perinatal death risk. A relatively higher educational status and maternal age of 30 years or higher, however, had protective effects.
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