E. Garne, H. Jakob Andersen
The impact of multiple pregnancies and malformations on perinatal mortality
Aim: To evaluate the impact of the rate of multiple pregnancies
and congenital malformations on perinatal
mortality.
Methods: The study is based on data from the perinatal
audit in Vejle County Denmark. Fetal deaths with gestational
age ?22 weeks and deaths in livebirths within the
first 28 days after birth were included in the calculated
perinatal mortality. Total number of births was 30,181 and
252 pregnancies and 268 fetuses/infants were evaluated.
The study period was 1995–2000. There was no routine
ultrasound screening for congenital malformations in the
county, though midtrimester ultrasound was used to
assess gestational age.
Results: Perinatal mortality was 8.9 per 1000 births with
no significant change over time. Rate of multiple pregnancies
was 1.94% ranging from 1.81% during the first
3 years to 2.06% for the last 3 years (not significant).
Fetuses and infants from multiple pregnancies contributed
18% of all deaths. Perinatal mortality for single
births was 7.6 per 1000 births and for multiple births
42.2/1000 (P<0.0001). The distribution of gestational
age for single and multiple births was highly significant
(P<0.0001) with 67% of multiple pregnancies with GA
<28 weeks compared to 26% of single pregnancies.
Nineteen percent of all deaths were caused by congenital
malformations and the majority of these were potentially
detectable by ultrasound investigation.
Conclusions: The increasing rate of multiple pregnancies
makes it difficult to see improvements in perinatal mortality.
Calculated from the perinatal mortality in single and
multiple pregnancies in Vejle County assisted conceptions
contribute with an an excess of 45 perinatal deaths
per year in Denmark. The difference between countries
in rate of multiple pregnancies and in prenatal ultrasound
screening recommendations for malformations makes it
difficult to compare perinatal mortality.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 05/2004
Pages: 215 - 219
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