Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021
Objective: We aimed to describe the epidemiology of intrauterine fetal deaths in multiethnic western French Guiana and to assess its main causes and risk factors. Study design: A retrospective descriptive study was conducted based on data from January 2016 to December 2021. All information on stillb...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161323000157 |
| _version_ | 1827924317412786176 |
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| author | Meredith Mathieu Véronique Lambert Gabriel Carles Olivier Picone Jean-François Carod Léo Pomar Mathieu Nacher Najeh Hcini |
| author_facet | Meredith Mathieu Véronique Lambert Gabriel Carles Olivier Picone Jean-François Carod Léo Pomar Mathieu Nacher Najeh Hcini |
| author_sort | Meredith Mathieu |
| collection | DOAJ |
| description | Objective: We aimed to describe the epidemiology of intrauterine fetal deaths in multiethnic western French Guiana and to assess its main causes and risk factors. Study design: 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. Results: 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. Conclusion: 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. |
| first_indexed | 2024-03-13T05:11:08Z |
| format | Article |
| id | doaj.art-9a226886655342db91670a13c4b53dd4 |
| institution | Directory Open Access Journal |
| issn | 2590-1613 |
| language | English |
| last_indexed | 2024-03-13T05:11:08Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj.art-9a226886655342db91670a13c4b53dd42023-06-16T05:11:33ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132023-06-0118100190Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021Meredith Mathieu0Véronique Lambert1Gabriel Carles2Olivier Picone3Jean-François Carod4Léo Pomar5Mathieu Nacher6Najeh Hcini7Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, French GuianaDepartment of Obstetrics and Gynaecology, West French Guiana Hospital Center, French GuianaDepartment of Obstetrics and Gynaecology, West French Guiana Hospital Center, French GuianaService de Gynécologie-Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes Cedex, France; Université de Paris, Paris, France; Inserm IAME-U1137, Paris, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), Vélizy, France; FHU Prema, Paris, FranceDepartment of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French GuianaSchool of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, 1011, Lausanne, Switzerland; Ultrasound and Fetal medicine, Department Woman-mother-child, Lausanne University Hospital and Lausanne University, 1011, Lausanne, SwitzerlandCentre Hospitalier de Cayenne, Cayenne, French Guiana; DFR Santé Université Guyane, CIC Inserm 1424, French GuianaDepartment of Obstetrics and Gynaecology, West French Guiana Hospital Center, French Guiana; DFR Santé Université Guyane, CIC Inserm 1424, French Guiana; Correspondence to: Department of Obstetrics and Gynaecology, 97320 West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.Objective: We aimed to describe the epidemiology of intrauterine fetal deaths in multiethnic western French Guiana and to assess its main causes and risk factors. Study design: 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. Results: 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. Conclusion: 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.http://www.sciencedirect.com/science/article/pii/S2590161323000157Stillbirth etiologyIntrauterine deathFetal deathInfectionAmazon basinFrench Guiana |
| spellingShingle | Meredith Mathieu Véronique Lambert Gabriel Carles Olivier Picone Jean-François Carod Léo Pomar Mathieu Nacher Najeh Hcini Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 European Journal of Obstetrics & Gynecology and Reproductive Biology: X Stillbirth etiology Intrauterine death Fetal death Infection Amazon basin French Guiana |
| title | Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 |
| title_full | Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 |
| title_fullStr | Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 |
| title_full_unstemmed | Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 |
| title_short | Incidence, causes, and risk factors of stillbirth in an Amazonian context: Saint Laurent du Maroni maternity ward 2016–2021 |
| title_sort | incidence causes and risk factors of stillbirth in an amazonian context saint laurent du maroni maternity ward 2016 2021 |
| topic | Stillbirth etiology Intrauterine death Fetal death Infection Amazon basin French Guiana |
| url | http://www.sciencedirect.com/science/article/pii/S2590161323000157 |
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