Understanding Stillbirth - the Basics

What Is Stillbirth?

Stillbirth is the delivery, after the 20th week of pregnancy, of a baby who has died. Loss of a fetus before the 20th week of pregnancy is called a miscarriage.

A baby is stillborn in about 1 in 200 pregnancies. Because many stillbirths occur in what appear to be normal pregnancies, the parents-to-be are rarely prepared for this devastating outcome.

Most women who have a stillbirth will be able to have a healthy baby in their next pregnancy. If the stillbirth was caused by a chromosomal or umbilical cord problem, the chances of recurrence are small. If the cause was a chronic maternal illness or a genetic disorder, the risk is somewhat higher. On average, the chance of a successful future pregnancy is more than 90%.

What Causes Stillbirth?

Often, there's no known reason for a stillbirth. In about half of all cases, the specific cause for a stillbirth is unknown.

• One of the most important known causes is birth defects, with or without a chromosomal abnormality.
• Umbilical cord problems also cause stillbirths. In a prolapsed umbilical cord, the cord comes out of the vagina before the baby, blocking the oxygen supply before the baby can breathe on its own.
• Problems with the placenta, which nourishes the baby, can sometimes lead to a stillbirth. In a placental abruption, the placenta separates too soon from the uterine wall.
• A mother's medical condition that existed before or developed during the pregnancy can lead to stillbirth. Women are at increased risk if they have insulin-dependent diabetes or untreated diabetes before or during pregnancy. High blood pressure -- particularly pregnancy-induced high blood pressure or preeclampsia -- is another major cause of stillbirth.
• Sometimes the fetus may grow too slowly. This condition, called intrauterine growth restriction or IUGR, puts the fetus at risk of dying from lack of nutrition.
• Other causes of stillbirth include the use of street drugs (especially cocaine), severe nutritional deficiencies, infections during pregnancy, and exposure to environmental agents such as pesticides or carbon monoxide.

Am I at Risk for a Stillbirth?

Factors that increase the risk of a stillbirth are alcohol use, drug abuse, and cigarette smoking. Obesity and a history of a previous stillbirth also increase a woman's risk. Women who have certain medical conditions, such as diabetes or high blood pressure, face an increased chance of stillbirth -- especially if these conditions aren't under control. Teens under the age of 15 and women older than their mid-30s also have an increased risk of stillbirth.