Extreme parity and the risk of stillbirth

Muktar H. Aliyu, Hamisu M. Salihu, Louis G. Keith, John E Ehiri, M. Aminul Islam, Pauline E. Jolly

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: We examined the relationship between extreme parity and risk for stillbirth in the United States. Methods: Singleton deliveries at 20 weeks of gestation or later in the United States from 1989 through 2000 were analyzed. Risk for stillbirth in women with 1-4 (moderate parity, category I), 5-9 (high parity, category II), 10-14 (very high parity, category III), and 15 or more (extremely high parity, category IV) prior live births were computed using logistic regression. Results: Overall, 27,069,385 births, including 1,206 to extremely high parity mothers, were analyzed. Of the 81,386 stillbirths, 71,623 (2.8/1,000), 9,206 (5.0/1,000), 531 (14.4/1,000), and 26 (21.6/1,000) cases occurred among category I, category II, category III, and category IV gravidas, respectively. With category I as referent category, the odds ratio for stillbirth increased consistently with ascending parity after adjusting for potential confounders: category II (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.07), category III (OR 1.97, 95% CI 1.81-2.15), and category IV (OR 2.31, 95% CI 1.56-3.42) (P for trend < .001). Among extremely high parity women (category IV), the odds ratio for stillbirth also increased with unit increment in the number of prior live births: 15 (OR 2.72, 95% CI 1.29-5.74), 1 6 (OR 3.1 4, 95% CI 1.1 7-8.41), 17 (OR 6.11, 95% CI 2.56-16.5), and 18 or more prior live births (OR 16.17, 95% CI 8.77-29.82) (P for trend < .001). Conclusions: The risk for stillbirth is substantially elevated among very high and extremely high parity women, and care providers may consider these groups for targeted periconceptional counseling.

Original languageEnglish (US)
Pages (from-to)446-453
Number of pages8
JournalObstetrics and Gynecology
Volume106
Issue number3
StatePublished - Sep 2005
Externally publishedYes

Fingerprint

Stillbirth
Parity
Odds Ratio
Confidence Intervals
Live Birth
Counseling
Logistic Models
Mothers
Parturition
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Aliyu, M. H., Salihu, H. M., Keith, L. G., Ehiri, J. E., Islam, M. A., & Jolly, P. E. (2005). Extreme parity and the risk of stillbirth. Obstetrics and Gynecology, 106(3), 446-453.

Extreme parity and the risk of stillbirth. / Aliyu, Muktar H.; Salihu, Hamisu M.; Keith, Louis G.; Ehiri, John E; Islam, M. Aminul; Jolly, Pauline E.

In: Obstetrics and Gynecology, Vol. 106, No. 3, 09.2005, p. 446-453.

Research output: Contribution to journalArticle

Aliyu, MH, Salihu, HM, Keith, LG, Ehiri, JE, Islam, MA & Jolly, PE 2005, 'Extreme parity and the risk of stillbirth', Obstetrics and Gynecology, vol. 106, no. 3, pp. 446-453.
Aliyu MH, Salihu HM, Keith LG, Ehiri JE, Islam MA, Jolly PE. Extreme parity and the risk of stillbirth. Obstetrics and Gynecology. 2005 Sep;106(3):446-453.
Aliyu, Muktar H. ; Salihu, Hamisu M. ; Keith, Louis G. ; Ehiri, John E ; Islam, M. Aminul ; Jolly, Pauline E. / Extreme parity and the risk of stillbirth. In: Obstetrics and Gynecology. 2005 ; Vol. 106, No. 3. pp. 446-453.
@article{76dab3c3807d485e84a0833e330caab0,
title = "Extreme parity and the risk of stillbirth",
abstract = "Objective: We examined the relationship between extreme parity and risk for stillbirth in the United States. Methods: Singleton deliveries at 20 weeks of gestation or later in the United States from 1989 through 2000 were analyzed. Risk for stillbirth in women with 1-4 (moderate parity, category I), 5-9 (high parity, category II), 10-14 (very high parity, category III), and 15 or more (extremely high parity, category IV) prior live births were computed using logistic regression. Results: Overall, 27,069,385 births, including 1,206 to extremely high parity mothers, were analyzed. Of the 81,386 stillbirths, 71,623 (2.8/1,000), 9,206 (5.0/1,000), 531 (14.4/1,000), and 26 (21.6/1,000) cases occurred among category I, category II, category III, and category IV gravidas, respectively. With category I as referent category, the odds ratio for stillbirth increased consistently with ascending parity after adjusting for potential confounders: category II (odds ratio [OR] 1.05, 95{\%} confidence interval [CI] 1.02-1.07), category III (OR 1.97, 95{\%} CI 1.81-2.15), and category IV (OR 2.31, 95{\%} CI 1.56-3.42) (P for trend < .001). Among extremely high parity women (category IV), the odds ratio for stillbirth also increased with unit increment in the number of prior live births: 15 (OR 2.72, 95{\%} CI 1.29-5.74), 1 6 (OR 3.1 4, 95{\%} CI 1.1 7-8.41), 17 (OR 6.11, 95{\%} CI 2.56-16.5), and 18 or more prior live births (OR 16.17, 95{\%} CI 8.77-29.82) (P for trend < .001). Conclusions: The risk for stillbirth is substantially elevated among very high and extremely high parity women, and care providers may consider these groups for targeted periconceptional counseling.",
author = "Aliyu, {Muktar H.} and Salihu, {Hamisu M.} and Keith, {Louis G.} and Ehiri, {John E} and Islam, {M. Aminul} and Jolly, {Pauline E.}",
year = "2005",
month = "9",
language = "English (US)",
volume = "106",
pages = "446--453",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Extreme parity and the risk of stillbirth

AU - Aliyu, Muktar H.

AU - Salihu, Hamisu M.

AU - Keith, Louis G.

AU - Ehiri, John E

AU - Islam, M. Aminul

AU - Jolly, Pauline E.

PY - 2005/9

Y1 - 2005/9

N2 - Objective: We examined the relationship between extreme parity and risk for stillbirth in the United States. Methods: Singleton deliveries at 20 weeks of gestation or later in the United States from 1989 through 2000 were analyzed. Risk for stillbirth in women with 1-4 (moderate parity, category I), 5-9 (high parity, category II), 10-14 (very high parity, category III), and 15 or more (extremely high parity, category IV) prior live births were computed using logistic regression. Results: Overall, 27,069,385 births, including 1,206 to extremely high parity mothers, were analyzed. Of the 81,386 stillbirths, 71,623 (2.8/1,000), 9,206 (5.0/1,000), 531 (14.4/1,000), and 26 (21.6/1,000) cases occurred among category I, category II, category III, and category IV gravidas, respectively. With category I as referent category, the odds ratio for stillbirth increased consistently with ascending parity after adjusting for potential confounders: category II (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.07), category III (OR 1.97, 95% CI 1.81-2.15), and category IV (OR 2.31, 95% CI 1.56-3.42) (P for trend < .001). Among extremely high parity women (category IV), the odds ratio for stillbirth also increased with unit increment in the number of prior live births: 15 (OR 2.72, 95% CI 1.29-5.74), 1 6 (OR 3.1 4, 95% CI 1.1 7-8.41), 17 (OR 6.11, 95% CI 2.56-16.5), and 18 or more prior live births (OR 16.17, 95% CI 8.77-29.82) (P for trend < .001). Conclusions: The risk for stillbirth is substantially elevated among very high and extremely high parity women, and care providers may consider these groups for targeted periconceptional counseling.

AB - Objective: We examined the relationship between extreme parity and risk for stillbirth in the United States. Methods: Singleton deliveries at 20 weeks of gestation or later in the United States from 1989 through 2000 were analyzed. Risk for stillbirth in women with 1-4 (moderate parity, category I), 5-9 (high parity, category II), 10-14 (very high parity, category III), and 15 or more (extremely high parity, category IV) prior live births were computed using logistic regression. Results: Overall, 27,069,385 births, including 1,206 to extremely high parity mothers, were analyzed. Of the 81,386 stillbirths, 71,623 (2.8/1,000), 9,206 (5.0/1,000), 531 (14.4/1,000), and 26 (21.6/1,000) cases occurred among category I, category II, category III, and category IV gravidas, respectively. With category I as referent category, the odds ratio for stillbirth increased consistently with ascending parity after adjusting for potential confounders: category II (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.07), category III (OR 1.97, 95% CI 1.81-2.15), and category IV (OR 2.31, 95% CI 1.56-3.42) (P for trend < .001). Among extremely high parity women (category IV), the odds ratio for stillbirth also increased with unit increment in the number of prior live births: 15 (OR 2.72, 95% CI 1.29-5.74), 1 6 (OR 3.1 4, 95% CI 1.1 7-8.41), 17 (OR 6.11, 95% CI 2.56-16.5), and 18 or more prior live births (OR 16.17, 95% CI 8.77-29.82) (P for trend < .001). Conclusions: The risk for stillbirth is substantially elevated among very high and extremely high parity women, and care providers may consider these groups for targeted periconceptional counseling.

UR - http://www.scopus.com/inward/record.url?scp=23944508552&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23944508552&partnerID=8YFLogxK

M3 - Article

C2 - 16135572

AN - SCOPUS:23944508552

VL - 106

SP - 446

EP - 453

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 3

ER -