Risk Factors Of Stillbirth In Rural China

Objective:To identify the risk factors of stillbirth in rural China by analyzing data collected by"National Free Preconception Health Examination Project".Study Design:"National Free Preconception Health Examination Project" was conducted in rural China from January 2010.By December 2012,248501 families from 220 counties of 31 provinces in China planning to deliver a baby within 6 months were enrolled.Both parental basic characteristics,childbearing history,living habit,and other exposing status before and during pregnancy were collected by questionnaires,and their pregnancy outcomes were recorded by doctors.Nested case-control study was conducted,and propensity score matching method was used to find 8 controls for each case,confounding factors were adjusted in this procedure.T test,x2 test and multi-level logistic regression was used to compare the exposing rates in case and control group.Results:Mothers' age,pregnancy times,education level,father's job,and area distribution were different between case group and control group and different exposing groups,these factors were considered as confounding factors and were adjusted by propensity score matching.By applying x2 test,maternal exposure to a lack or loss of appetite for vegetables(OR=2.25,95%CI of(1.16?4.39)),passive smoking,pesticide(OR=2.24,95%CI of(1.26?3.97)),pressure(compared with no pressure,OR of some pressure was 1.37,with 95%CI of(1.06?1.78)),hypertension(OR=1.73,95%CI of(1.17-2.56)),folic acid intake(compared with no intake,OR of intake 3 months before pregnancy was 0.72,with 95%CI of(0.59-0.89)),OR of intake 1-2 months before pregnancy was 0.71,with 95%CI of(0.55-0.92)),OR of intake after pregnancy was 0.81,with 95%CI of(0.65-1.02))were related with stillbirth.Paternal exposure to organic solvent(OR=1.71,95%CI of(1.05-2.77)),pressure in life or work(OR=2.41,95%CI of(1.37?4.23))were related with stillbirth.The results of multi-level logistic regression were basically accordance with results of X2 test,after adjusting the effect of level two,province,maternal exposure to pesticide(OR=1.9,95%CI of(1.06?3.39)),maternal hypertension(OR=1.58,95%CI of(1.07-2.34)),a lack or loss of appetite for vegetables(OR=1.99,95%CI of(1.00?3.93)),maternal pressure(compared with no pressure,OR of a little pressure was 1.34,with 95%CI of(1.02?1.76)),paternal smoking(OR=1.22,95%CI of(1.02?1.46)),paternal exposing to Organic solvents(OR=1.64,95%CI of(1.01?2.69))were risk factors of stillbirth.Folic acid intake was a protect factor(OR=0.72,with 95%CI of(0.59-0.89)for folic acid intake 3 months before pregnancy,OR=0.71,with 95%CI of(0.55?0.92)for folic acid intake 1-2 months before pregnancy,OR=0.81,with 95%CI of(0.65?1.02)for folic acid intake after pregnancy)of stillbirth.Conclusion:Maternal exposure to pesticide,a lack or loss of appetite for vegetables,hypertension,paternal smoking,paternal exposure to organic solvent were risk factors of stillbirth.Folic acid intake was protect factor of stillbirth.