GENITAL INFECTIONS IN THE ETIOLOGY OF LATE FETAL DEATH - AN INCIDENT CASE-REFERENT STUDY

Women with prelabour fetal death in the third trimester were recruited in order to study the association between intra-uterine death and mat ernal genital colonization of bacteria. Fifty-eight women with verifie d fetal death were compared with a group of 58 women matched for age, parity and gestational length (the first referent group) and with wome n delivering liveborn neonates (second referent group). Cultures from the vagina, the endocervix, the amniotic fluid, the placenta, the conj unctivae of the newborn and the secretion of gastric aspirate of the n ewborn were carried out. Blood was taken for haemoglobin, thick film ( malaria) and syphilis and HIV serology. Cases were more affected by pr evious stillbirths than first referents (OR=11.88). Preterm delivery w as significantly more common in cases than in second referents (OR=57. 70). Cases had significantly more often < 3 ANC visits (OR=2.81), Case s had a lower body mass index than first referents (OR=2.38). Temperat ure greater than or equal to 37 degrees C was 12 times more frequent i n cases than in first referents (OR=21.20) and four times more frequen t than in second referents (OR=6.60). Average birth weight among still borns was 1954 g and in liveborns 3223 g (P=0.001). The corresponding prevalence of LBW was 78% in cases and 0% among second referents (P<0. 001). Histological chorioamnionitis was significantly prevalent in cas es than in second referents (OR=4.97). Syphilis was significantly more common in cases than in first (OR=7.71) and in second referents (OR=5 .30). In the vaginal and endocervical cultures no clearcut pattern was demonstrated, though E. coli was found in 25% of cardiac blood among stillborns at sterile autopsy.