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Influence of Adolescence and Obesity on the Rate of Stillbirth

Authors

  • Carri R. Warshak,

    Corresponding author
    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine
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  • Katherine B. Wolfe,

    1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine
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  • Kimberly A. Russell,

    1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine
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  • Mounira Habli,

    1. Division of Maternal Fetal Medicine, The Good Samaritan Hospital
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  • David F. Lewis,

    1. Children's and Women's Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Alabama, Mobile, AL
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  • Emily A. DeFranco

    1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine
    2. Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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  • The authors have no conflicts of interest or financial disclosures.

Correspondence:

Carri R. Warshak, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0526, USA.

E-mail: eaglercr@ucmail.uc.edu

Abstract

Background

We hypothesise that the rate of stillbirth is increased in mothers younger than 18 years of age compared to adult mothers, and that obesity further increases the risk of stillbirth in this population.

Methods

We conducted a population-based cohort study comparing rates of stillbirth between adolescent, defined as young women under the age of 18 and adult women. We then compared the rate of stillbirth in normal weight vs. obese adolescents. These effects were stratified according to gestational age. Log-binomial regression models were used to estimate the effect of adolescence and obesity on stillbirth risk while adjusting for important confounders. Risk ratios (RR) with 95% confidence intervals [CI]were calculated.

Results

We reviewed data from 650 760 births in Missouri between 1998 and 2005. Stillbirth rates were 6.7 and 4.1 per 1000 in adolescents and adult women, respectively (RR 1.2, 95% CI 1.03–1.5). A higher proportion of stillbirths occurred prior to 28 weeks in adolescents vs. adults (53% vs. 37% respectively, P = 0.002). The risk of stillbirth in obese adolescents was further increased over normal weight adolescents (adjusted RR [aRR] 1.7, 95% CI 1.02–2.9).

Conclusion

Adolescent pregnancies, particularly obese adolescents, are at an increased risk of stillbirth.

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