Pregnancies should be closely monitored and antenatal interventions and care should be offered at the first sign of increased risk of distress or danger.
A new study led by an Indian-British scientist shows that women who have experienced a stillbirth have up to a four-fold increased risk of stillbirth in a second pregnancy compared to those who had an initial live birth. Stillbirth is still a major public health concern despite rates falling across high income countries. Stillbirth refers to fetal death at more than 20 weeks’ gestation or a birth weight of at least 400g.
"Stillbirth is one of the most common adverse obstetric outcomes and a traumatic experience for parents," explained India-born Sohinee Bhattacharya from the University of Aberdeen, Scotland. "Couples who have experienced a stillbirth need to understand why it happened and want to know the risk for future pregnancies," he noted.
They undertook systematic review and meta-analysis to examine the link between stillbirth in an initial pregnancy and risk of stillbirth in a subsequent pregnancy.
The team analyzed 13 cohort and three case-control studies from high-income countries. Data was collected for 3,412,079 women out of which 3,387,538 (99.3%) had a previous live birth and 24,541 (0.7%) had a stillbirth in an initial pregnancy.
Stillbirths occurred in the subsequent pregnancy for 14,283 women: 606 of 24,541 (2.5%) in women with a history of stillbirth and 13,677 of 3,387,538 (0.4%) in women with no history.
Women who had a stillbirth in an initial pregnancy had a nearly fivefold increased risk of stillbirth in a second pregnancy. This risk is higher than stillbirth linked with medical conditions such as diabetes or hypertension.
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The study appeared in The BMJ.
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