Determining risk factors for intrapartum fetal death

OBJECTIVE: To determine the antenatal and intrapartum risk factors for intr apartum fetal death (IPFD). STUDY DESIGN: We analyzed 72,875 singleton deliveries > 500 g between the y ears 1990 and 1997. In order to find independent factors contributing to IP FD, a multiple logistic regression model was constructed. RESULTS: During the study period there were 64 cases of IPFD. Birth weight tons inversely associated with IPFD in the multivariate analysis. Other sig nificant factors in the multivariate analysis were mothers older than 35 ye ars, polyhydramnios, congenital malformations, pathologic presentation, abr uptio placentae and cord prolapse. No association was found with maternal d iabetes or hypertension. CONCLUSION: IPFD was significantly associated with low birth weight, older maternal age, polyhydramnios, congenital malformations and pathologic prese ntation. Direct causes were abruptio placentae and cord prolapse. Pregnanci es in older women and those complicated by polyhydramnios and pathologic pr esentation should be carefully evaluated during pregnancy and delivery in o rder to decrease the incidence of IPFD.