Risk of Recurrent Stillbirth

Stillbirth is a terribly sad outcome, no matter what reason, including whether it was expected (as in the case of certain known fetal anomalies) or unexpected (such as in the case of umbilical cord accidents), or regardless of the timing (a fetal loss prior to 20 weeks is termed a miscarriage; after 20 weeks, it’s called a stillbirth).

Most people assume that stillbirth is “just one of those things” that sometimes happens, often with no reason. While this is true much of the time (even with an autopsy, many stillborn babies have no known cause of death; but many parents choose not to have an autopsy), other times, there are known reasons.

The American Pregnancy Association has a good, non-technical page about stillbirths, including causes, factors that increase the risk, and ways of prevention. For more in-depth information and many studies, ACOG’s Green Journal has a link on Prediction and Prevention of Stillbirth.

What got me thinking about this topic was this article, which says, “Conventional wisdom used to suggest that stillbirths had a very low recurrence per mother. New studies are revealing that subsequent pregnancies following fetal demise due to a cord accident have a 1 in 7 chance of ending with the same tragedy.”

The Green Journal article says, “There is a paucity of information on the outcome of pregnancies after stillbirth. Prior stillbirth is associated with a twofold to 10-fold increased risk of stillbirth in the future pregnancy. The risk depends on the etiology of the prior stillbirth, presence of fetal growth restriction, gestational age of the prior stillbirth, and race.”

I would not have known that stillbirth had that high of a rate of recurrence, especially if the stillbirth was due to a previous cord accident. You can bet I passed this information on to my friend who had a stillbirth a few years ago, due to an umbilical cord accident. While I would hate to cause her needless anxiety (should this baby be perfectly all right), I would hate it more if I didn’t tell her, and she lost another baby if it could have been prevented. Many fetal demises due to umbilical cord accidents have warning signs — usually a slowing down of fetal movement (as the baby tries to conserve oxygen for the heart and brain), but also sudden fetal hyperactivity and even fetal hiccups. All I can say, is, kick counts, kick counts, kick counts! It just might save your baby’s life.

5 Responses

  1. Thanks for posting this! It’s important to get the word out. While it’s sickening to imagine that this could happen to the same person twice, it’s important to note that there are ways of preventing it.
    As a woman who recently lost her son to a cord accident at 37 weeks, I’d rather be aware and nervous for the next one than have it happen again.
    Thanks again!

  2. Scary! I would say that it’s hard because we didn’t know why we had IUFD of a 16 week baby. The genetic and pathology reports were normal, and the cord looked good. At any rate, having had a death like that makes me ever aware how it can just happen without awareness. What is hard is being pregnant with an anterior placenta. It’s harder to feel kicks.

    I had a baby once who would seem to seize when I laid on my left side, so I learned to sleep on the right side. Never figured out what that was, but my mommy radar said it was not safe.

  3. Hi Kathy

    Thank you for this information.

    There are a few things pregnancy books do not reveal and THEY SHOULD.

    I did not count kicks and did not know Braxton Hicks can make you think your baby moved on his own.

    Peace
    Diana

  4. I’m so happy to see your post – and to know that finally we’re talking about this issue. Please visit us at http://www.starlegacyfoundation.org and http://www.seemefeelme.org – together we can do more!

  5. […] a higher risk of having another one. How much higher is the risk? Twofold to tenfold, according to one. That seems like a pretty big range, right? If the risk of stillbirth is 0.4% for a first-time […]

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