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What Is Stillbirth?

Stillbirth is the delivery of a dead baby after the 20th week of pregnancy and birth. Loss of a fetus before the 20th week of pregnancy is considered 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 It?

Very often there's no known reason for a stillbirth. Some known causes are birth defects, problems with the umbilical cord or placenta, or maternal conditions that existed before or developed during the pregnancy.

Some factors which 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. This is especially true if these conditions are not under control. Teens under the age of 15 and women older than their mid-30s have an increased risk of stillbirth.

Half the time, the specific reason for a stillbirth is unknown. One of the most important known causes is birth defects, with or without a chromosomal abnormality.

Placental problems can sometimes lead to a stillbirth. In the event known as placental abruption, the placenta separates too soon from the uterine wall.

Umbilical-cord problems also cause stillbirths. One such problem is a prolapsed cord, in which the cord comes out of the vagina before the baby. This can block the baby's oxygen supply before it is ready to breathe on its own.

Sometimes maternal illnesses 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 pre-eclampsia - 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 drugs (especially cocaine), serious nutritional deficiencies, infections during pregnancy and exposure to environmental agents such as pesticides or carbon monoxide.