Association of previous stillbirth with subsequent perinatal outcomes: a systematic review and meta-analysis of cohort studies - 26/07/24
, Kehu Yang, MD c, d, f, ⁎ Abstract |
Objective |
We conducted a systematic review and meta-analysis to examine the relationship between stillbirth and various perinatal outcomes in subsequent pregnancy.
Data Sources |
PubMed, the Cochrane Library, Embase, Web of Science, and CNKI databases were searched up to July 2023.
Study Eligibility Criteria |
Cohort studies that reported the association between stillbirth and perinatal outcomes in subsequent pregnancies were included.
Methods |
We conducted this systematic review and meta-analysis in accordance with the PRISMA guidelines. Statistical analysis was performed using R and Stata software. We used random-effects models to pool each outcome of interest. We performed a meta-regression analysis to explore the potential heterogeneity. The certainty (quality) of evidence assessment was performed using the GRADE approach.
Results |
Nineteen cohort studies were included, involving 4,855,153 participants. From these studies, we identified 28,322 individuals with previous stillbirths who met the eligibility criteria. After adjusting for confounders, evidence of low to moderate certainty indicated that compared with women with previous live births, women with previous stillbirths had higher risks of recurrent stillbirth (odds ratio, 2.68; 95% confidence interval, 2.01–3.56), preterm birth (odds ratio, 3.15; 95% confidence interval, 2.07–4.80), neonatal death (odds ratio, 4.24; 95% confidence interval, 2.65–6.79), small for gestational age/intrauterine growth restriction (odds ratio, 1.3; 95% confidence interval, 1.0–1.8), low birthweight (odds ratio, 3.32; 95% confidence interval, 1.46–7.52), placental abruption (odds ratio, 3.01; 95% confidence interval, 1.01–8.98), instrumental delivery (odds ratio, 2.29; 95% confidence interval, 1.68–3.11), labor induction (odds ratio, 4.09; 95% confidence interval, 1.88–8.88), cesarean delivery (odds ratio, 2.38; 95% confidence interval, 1.20–4.73), elective cesarean delivery (odds ratio, 2.42; 95% confidence interval, 1.82–3.23), and emergency cesarean delivery (odds ratio, 2.35; 95% confidence interval, 1.81–3.06) in subsequent pregnancies, but had a lower rate of spontaneous labor (odds ratio, 0.22; 95% confidence interval, 0.13–0.36). However, there was no association between previous stillbirth and preeclampsia (odds ratio, 1.72; 95% confidence interval, 0.63–4.70) in subsequent pregnancies.
Conclusion |
Our systematic review and meta-analysis provide a more comprehensive understanding of adverse pregnancy outcomes associated with previous stillbirth. These findings could be used to inform counseling for couples who are considering pregnancy after a previous stillbirth.
Le texte complet de cet article est disponible en PDF.Video |
(13.33 Mo)Video 1Video 1.
Deng. Previous stillbirths and subsequent perinatal outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol 2024.
Le texte complet de cet article est disponible en PDF.Key words : adverse pregnancy outcomes, fetal death, perinatal outcomes, risk, stillbirth, subsequent pregnancies
Plan
| X.D. and B.P. share first authorship. |
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| The authors report no conflict of interest. |
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| This research was funded by the Lanzhou Talent Innovation and Entrepreneurship Program (No.2021-RC-135), Natural Science Foundation of Gansu Province (No.23JRRA1388), and Lanzhou Science and Technology Planning Project (No.2022-3-15). The funders had no role in the design of the study; collection, analysis, or interpretation of the data; writing of the report; or the decision to submit the article for publication. |
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| PROSPERO registration: Date of PROSPERO registration was 07-11-2022 under number CRD42022344965. |
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| The abstract of this study was presented as a poster at the 17th National Conference on Perinatal Medicine of the Chinese Medical Association, Guangzhou, China, November 17–19, 2023. |
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| Declaration of generative AI in scientific writing: Generative AI or AI-assisted technologies were not used during the writing of this article. |
Vol 231 - N° 2
P. 211-222 - août 2024 Retour au numéro
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