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Title: Temporal trends in fetal mortality at and beyond term and induction of labor in Germany 2005-2012 : data from German routine perinatal monitoring
Authors : Schwarz, Christiane
Schäfers, Rainhild
Loytved, Christine
Heusser, Peter
Abou-Dakn, Michael
König, Thomas
Berger, Bettina
Published in : Archives of Gynecology and Obstetrics
Volume(Issue) : 293
Issue : 2
Pages : 335
Pages to: 343
Publisher / Ed. Institution : Springer
Publisher / Ed. Institution: Berlin
Issue Date: Feb-2016
License (according to publishing contract) : CC BY 4.0: Namensnennung 4.0 International
Type of review: Peer review (Publication)
Language : English
Subjects : Mortality; Fetal; Induction; Labour; Fetal mortality; Perinatal data; Post-dates; Postmaturity; Induction of labor
Subject (DDC) : 618: Gynecology, obstetrics and midwifery
Abstract: PURPOSE: While a variety of factors may play a role in fetal and neonatal deaths, postmaturity as a cause of stillbirth remains a topic of debate. It still is unclear, whether induction of labor at a particular gestational age may prevent fetal deaths. METHODS: A multidisciplinary working group was granted access to the most recent set of relevant German routine perinatal data, comprising all 5,291,011 hospital births from 2005 to 2012. We analyzed correlations in rates of induction of labor (IOL), perinatal mortality (in particular stillbirths) at different gestational ages, and fetal morbidity. Correlations were tested with Pearson's product-moment analysis (α = 5 %). All computations were performed with SPSS version 22. RESULTS: Induction rates rose significantly from 16.5 to 21.9 % (r = 0.98; p \ 0.001). There were no significant changes in stillbirth rates (0.28–0.35 per 100 births; r = 0.045; p = 0.806). Stillbirth rates 2009–2012 remained stable in all gestational age groups irrespective of induction. Fetal morbidity (one or more ICD-10 codes) rose significantly during 2005–2012. This was true for both children with (from 33 to 37 %, r = 0.784, p \ 0.001) and without (from 25 to 31 %, ( r = 0.920, p \ 0.001) IOL. CONCLUSIONS: An increase in IOL at term is not associated with a decline in perinatal mortality. Perinatal morbidity increased with and without indiction of labor.
Departement: Gesundheit
Organisational Unit: Institute of Midwifery (IHB)
Publication type: Article in scientific Journal
DOI : 10.1007/s00404-015-3795-x
ISSN: 0932-0067
Appears in Collections:Publikationen Gesundheit

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