Screening And Proper Care Could Prevent A Quarter Of U.S. Stillbirths: Study

About one out of every four stillbirths in the United States may be preventable, according to the findings of new research. 

In a study published this month in the medical journal Obstetrics & Gynecology, researchers warn that doctors can do much more to avoid stillborn infant deaths, indicating that aditional focus needs to be placed on disorders concerning the placenta and pregnancy complications to improve stillbirth rates.

Researchers conducted an analysis of 512 stillbirths with potentially preventable causes using data from the Stillbirth Collaborative Research Network from 2006 to 2008; a case-controlled study of stillbirths in the U.S. across all ethnicities, populations, races, and geographical locations in the United States.

Each stillbirth was given probable and possible causes of death. Researchers then determined the preventable stillbirths in fetuses older than 24 weeks gestation and weighing over 500 grams, or about 1 pound.

Of the stillbirths examined, 13% were due to placental insufficiency, a complication during pregnancy where the placenta cannot deliver adequate nutrients and oxygen to the fetus and cannot support the development of the baby. Medical pregnancy complications accounted for 6%, mothers who were hypertensive during pregnancy accounted for 4%, preterm labor 3%, intrapartum complications, or complications during the actual delivery, 2%, and carrying multiple fetuses accounted for 1% of the stillbirths.

Overall, 27 stillbirths fit two or more categories, leaving 22%, or 114 potentially preventable stillbirths.

Most stillbirths occurred after 37 weeks of gestation. About one-third of stillbirths occurring after 37 weeks had “minimum risk of prematurity.” Similarly, about half of stillbirths occurring after 37 weeks were potentially preventable.

Researchers noted no differences in stillbirth rates across various races and ethnicities. However, a higher proportion of women with public insurance were likely to have preventable stillbirths, nearly 60%.

Tobacco use was also more common among women who had preventable stillbirths. Women without prenatal care were less likely to have a preventable stillbirth than those with prenatal care.

Many researchers and doctors debate what exactly constitutes a preventable stillbirth or exactly how to prevent them. However, increased surveillance and improved resources at the ready during potentially complex deliveries may be two key steps, as many stillbirths occur during delivery or occur from preventable infections.

Researchers also highlighted the importance of identifying placental insufficiency early to provide adequate nutrients and oxygen to the fetus, before it is too late.

Roughly 1% of all pregnancies are stillbirths, causing more than 24,000 infant stillbirths each year in the U.S. Over the last 10 years stillbirth rates have remained steady across the U.S., despite initially declining from 2000 to 2006.

While 98% of stillbirths globally occur in low-income countries, the rates of stillbirths in the U.S. is now higher than in other high-income developed countries.