Risk factors of Stillbirth
Are you a clinician? If so, here is a page of published research data to help you identify risk factors for stillbirth. Through prenatal care, an expectant family's individual history should be considered and a conversation relating to potential risk factors is suggested.
This information is not intended to replace the advice of a trained medical professional. Still Aware provides this knowledge as a courtesy, not as a substitute for personalised medical advice and disclaims any liability for the decisions you make based on this information. Rather, the organisation encourages expectant families and clinicians to ask the questions. Quality antenatal care that is accessible to all, has the potential to reduce stillbirth rates in high-income countries. Multiple risk factors would warrant closer or more regular monitoring throughout pregnancy, particularly in the third trimester.
Characteristics of at-risk mothers may include:
- Primiparity (first-time mothers) i
- Maternal age (less than 18 or 35years +) ii
- Assisted reproduction (IVF) pregnancy ii
- BMI (30 or above) ii
- Maternal ethnic origin (South Asian descent, Australian indigenous & new immigrant group) ii
- Previous Stillbirth ii
- Previous Caesarean section ii
- Diabetes (pre-existing & Gestational) ii
- Smoking ii
- Alcohol ii
- Illicit drug use ii
- Lack of folic acid ii
- High blood pressure (Pre-existing and Pre-eclampsia) ii
- Multiple Pregnancy ii
- Infection ii
- Low socioeconomic status ii
- Poor antenatal attendance (less than 50% of planned visits attended) iii
Characteristics of an at-risk baby may include:
- Decreased fetal movement (irregular from what’s normal baby) ii for the individual
- Erratic increased fetal movement (crazy, insane or out-of-control movement from what is normal for the individual baby) iv
- Fetal growth restriction (crossing centiles from the expected growth curve for that baby) ii
- Low amniotic fluid v
- Placental blood flow restriction vi
- Gestational age 41 weeks or more ii
- Male ii
Published articles about finding the cause of stillbirth:
Microarray analysis is more likely than karyotype analysis to provide a genetic diagnosis, primarily because of its success with nonviable tissue, and is especially valuable in analyses of stillbirths with congenital anomalies or in cases in which karyotype results cannot be obtained. vii
i The Lancet 2016, ''Ending Preventable Stillbirth"
ii The BMJ 2013, "Maternal and fetal risk factors for stillbirth: population based study"
iii Semantic Scholar 2012, "Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study."
iv BMC Pregnancy and Childbirth 2015, "An international internet survey of the experiences of 1,714 mothers with a late stillbirth: the STARS cohort study"
v American Journal of Obstetrics & Gynecology 2015, "Multivariate model to predict successful vaginal delivery".
vi Tommy's UK 2017, "Causes of Stillbirth"