Table of Contents
Advances in Epidemiology
Volume 2015 (2015), Article ID 819146, 6 pages
http://dx.doi.org/10.1155/2015/819146
Research Article

Previous Preterm Birth and Current Maternal Complications as a Risk Factor of Subsequent Stillbirth

1Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, AHC2 576A, Miami, FL 33199, USA
2Department of Public Health, College of Health and Human Services, Western Kentucky University, 1906 College Heights Boulevard, Bowling Green, KY 42101, USA
3Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33012, USA
4Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA

Received 29 April 2015; Revised 8 July 2015; Accepted 15 July 2015

Academic Editor: Peter N. Lee

Copyright © 2015 Boubakari Ibrahimou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To examine the association between previous preterm birth and the risk of stillbirth. Methods. This population-based retrospective cohort study analyzed live births and stillbirth records in Missouri (1989–1997). The main outcome of interest was stillbirth occurrence while the exposures were prior preterm birth. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression. Results. Women who had a previous preterm birth have 63% increased odds of stillbirth in singleton pregnancies and 75% increased odds in twins as compared to those who did not have a preterm birth in a prior pregnancy (AOR = 1.63, 95% CI = 1.41–1.88 and AOR = 1.75, 95% CI = 1.20–2.56), respectively. The most significant risk factor for stillbirth in singleton pregnancies was uterine bleeding (AOR = 5.89, 95% CI = 5.13–6.76). In twin pregnancies, it was the condition hydramnios/oligohydramnios (AOR = 4.72, 95% CI = 3.70–6.02). Eclampsia was associated with a heightened risk of stillbirth in singletons (AOR = 2.45, 95% CI = 1.41–4.12), but not in twins (AOR = 0.96, 95% CI = 0.13–7.00). Black mothers were more likely than white to experience stillbirth (AOR = 2.10, 95% CI = 1.99–2.22 for singletons and AOR = 1.51, 95% CI = 1.27–1.79 for twins). Conclusion. Stillbirth is a vital public health issue and its etiology is not well understood. Previous history of preterm birth was found to be associated with future stillbirth. Targeted early medical and obstetric care and interventions among women with preterm birth history may potentially reduce the likelihood of stillbirth.