STILLBIRTH CAUSES AND RISKS, Daniel Saltzman, MD (Digital)
Stillbirth or fetal death after 20 weeks of pregnancy is one of the most common pregnancy outcomes. It complicates 1 in 160 deliveries or 6.2 per 1,000 births.
The most prevalent risk factors for stillbirth are non-Hispanic black race, a woman having her first child, advanced maternal age (more than or equal to age 35) and obesity. Medical diseases such as diabetes, hypertension (high blood pressure), kidney disease, thyroid disorders and multiple gestations such as twin or triplets are examples. Infections such as human parvovirus (Fifth’s disease) syphilis, streptococcal infection, and listeria are also risk factors. Listeria is a type of infection found in some contaminated foods. These include uncooked meats, uncooked vegetables, unpasteurized milk, foods made from unpasteurized milk (unpasteurized cheese) and processed foods. Listeria is killed by pasteurization and cooking. There is a chance that contamination may occur in ready to eat food such as hot dogs and deli meats because contamination may occur after cooking and before packaging.
There are modifiable risk factors such as smoking and maternal overweight or obesity. In the United States over 50% of all women ages 15-44 are either overweight or obese. Not smoking and achieving a normal weight are goals that women should try and achieve prior to becoming pregnant.
Some causes of stillbirth include fetal birth defects or genetic abnormalities such as Down syndrome, Turner’s syndrome, Trisomy 18 or Trisomy 13.
Although many stillbirths are attributed to umbilical cord accidents, this diagnosis should be made with caution, as a cord around a baby’s neck is common. This diagnosis should be confirmed by examination of the cord by a physician who specializes in this (a pathologist) and other causes should be excluded.
A fetal to maternal hemorrhage, which means a large amount of the baby’s blood goes into the mother’s blood, is another cause. The baby loses its blood and, therefore, dies from not having enough blood left in its body to survive. Also, there is a condition called antiphospholipid antibody syndrome. It’s when your immune system (our bodies defense system) attacks some of the normal proteins in your blood causing blood clots in your arteries or veins. Blood clots in the babies’ placenta may not allow adequate blood flow to get to the baby and cause stillbirth.
If you have had a stillbirth it is important to speak with your obstetrical to discuss the cause, if known, and how your pregnancy care will chance to help prevent a recurrence. The vast majority of women will be able to have a successful pregnancy in the future.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!