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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?

In about half of all cases, the specific cause for a stillbirth is unknown. The causes of a stillbirth that are understood are:

  • Birth defects, with or without a chromosomal abnormality
  • Umbilical cord problems; 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; 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; 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.
  • Intrauterine growth restriction or IUGR, which puts the fetus at risk of dying from lack of nutrition
  • Use of street drugs (especially cocaine), severe nutritional deficiencies, infections during pregnancy, and exposure to environmental agents such as pesticides or carbon monoxide 
  • A personal or family history of thrombosis, thrombophlebitis, or pulmonary embolism, blood-clotting conditions

Am I at Risk for a Stillbirth?

Factors that increase the risk of a stillbirth are alcohol use, drug abuse, and cigarette smoking. Other factors include obesity and a history of a previous stillbirth, and diabetes and high blood pressure that aren't properly managed. Teens under the age of 15 and women older than their mid-30s also have an increased risk of stillbirth.

WebMD Medical Reference

Reviewed by Mikio A. Nihira, MD on April 24, 2012

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