Perinatal mortality is usually calculated according to the World Health Organisation as stillbirth and first week mortality at a specified week of gestation divided by all births at that same gestational week. This is not a meaningful indicator of the risk of future perinatal death for a living fetus. We have developed an approach to estimate the prospective risk of perinatal mortality. Data were derived from the Perinatal Database of the Netherlands. We calculated the prospective risk of perinatal mortality by dividing all future perinatal deaths from a certain week of gestation by all fetuses that remained undelivered. Using this statistic there is a decline in risk from 16 to 39 gestational weeks and an increase from 39 weeks onwards.
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http://dx.doi.org/10.1016/0028-2243(93)90020-d | DOI Listing |
BMC Pregnancy Childbirth
January 2025
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah Health, 30 N. Mario Capecchi Dr., Level 5 South, Salt Lake City, UT, 84132, USA.
Background: Fetal growth restriction (FGR) is a leading risk factor for stillbirth, yet the diagnosis of FGR confers considerable prognostic uncertainty, as most infants with FGR do not experience any morbidity. Our objective was to use data from a large, deeply phenotyped observational obstetric cohort to develop a probabilistic graphical model (PGM), a type of "explainable artificial intelligence (AI)", as a potential framework to better understand how interrelated variables contribute to perinatal morbidity risk in FGR.
Methods: Using data from 9,558 pregnancies delivered at ≥ 20 weeks with available outcome data, we derived and validated a PGM using randomly selected sub-cohorts of 80% (n = 7645) and 20% (n = 1,912), respectively, to discriminate cases of FGR resulting in composite perinatal morbidity from those that did not.
BMC Public Health
January 2025
Department of Women & Children's Health, King's College London, London, UK.
Background: Recurrent early pregnancy loss [rEPL] is a traumatic experience, marked by feelings such as grief and depression, and often anxiety. Despite this, the psychological consequences of rEPL are often overlooked, particularly when considering future reproductive health or approaching subsequent pregnancies. The SARS-CoV-2 pandemic led to significant reconfiguration of maternity care and a negative impact on the perinatal experience, but the specific impact on women's experience of rEPL has yet to be explored.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Pediatrics, University of Washington, Seattle, Washington, United States of America.
Aim: To evaluate the impact of heart rate-guided basic resuscitation compared to Helping Babies Breathe on neonatal outcomes and resuscitation practices in the Democratic Republic of the Congo.
Methods: We conducted a pre-post clinical trial comparing heart rate-guided basic resuscitation to Helping Babies Breathe in three facilities, enrolling in-born neonates ≥28 weeks gestation. We collected observational data during a convenience sample of resuscitations and extracted clinical data from the medical record for all participants.
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