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Stillbirths More Common for Women With Previous Infant Deaths, Study Finds

Enlarge image Stillbirth More Common for Women With Previous Infant Deaths

Stillbirth More Common for Women With Previous Infant Deaths

Stillbirth More Common for Women With Previous Infant Deaths

Sean Gallup/Getty Images

About 6 million pregnancies occur in the U.S. each year and of those about 26,000 result in a stillbirth, according to the American Pregnancy Association.

About 6 million pregnancies occur in the U.S. each year and of those about 26,000 result in a stillbirth, according to the American Pregnancy Association. Photographer: Sean Gallup/Getty Images

A woman who loses a child during the baby’s first year of life is at risk of having a stillbirth in her next pregnancy, according to research that underscores the importance of good health before conception.

Women who lose a child in the infant’s first year of life were three times more likely to have a stillbirth than women whose children survive to their first birthday, research today in BJOG: An International Journal of Obstetrics and Gynecology found. Black women were more likely than white women to suffer a subsequent stillbirth, the study showed.

Today’s findings are one of the first to link prior infant death with a subsequent stillbirth and the first to show the implications for black women, study author Hamisu Salihu said. Reducing weight, stopping smoking and becoming as healthy as possible before getting pregnant may prevent stillbirths, although genetic factors may also be at play, he said.

“If they experience infant mortality in the first pregnancy they should be aware they could lose their baby again in the second pregnancy very early,” said Salihu, a professor of epidemiology and obstetrics and gynecology at the University of South Florida in Tampa, in a telephone interview today. “Women should be aware that all is not lost. They may have a risk factor that is modifiable and something could be done to prevent that from happening.”

About 6 million pregnancies occur in the U.S. each year and of those about 26,000 result in a stillbirth, according to the American Pregnancy Association. A stillbirth occurs when a fetus dies in the womb after 20 weeks of a pregnancy. More than 27,000 infants die every year before their first birthday.

Research Findings

Researchers in the study used data from the state of Missouri from 1989 to 2005 and included 320,350 women who had two pregnancies of only one child each.

They found that 2,483 women had babies who died during the first year of life, while the rest had children who survived.

In the second pregnancy, there were 1,347 stillbirths overall. Of those, 34 occurred in women who experienced a previous infant death. The study showed that women with a prior infant death were 2.91 times more likely to experience a subsequent stillbirth then women whose child survived the first year of life.

Black women with a prior infant death were more than four times more likely to have a subsequent stillbirth compared with black women whose children survived the first year and eight times more likely compared with white women with no prior infant death, the researchers said. White women with a previous infant death were almost twice as likely to have a subsequent stillbirth compared with their white counterparts.

Health Problems

Stillbirths can occur if the baby has birth defects, there are placenta problems, poor fetal growth, infections or chronic health problems in the mother, including high blood pressure and diabetes, according to the March of Dimes. Women are more likely to have a stillbirth if they are older than age 35, obese and black.

Salihu said women may be more likely to have subsequent tillbirths after their first child dies because of shared genetic risk factors between the children. Also, modifiable risk factors, like obesity and smoking in the mother, may persist into the second pregnancy causing the baby to be lost earlier during pregnancy rather than after being born, he said.

In the study, mothers with a prior infant death were more likely to have pregnancy complications, including diabetes, high blood pressure and having their placenta separate from the uterus wall, than those whose infants survived the first year of life, the authors wrote.

“Stillbirth and infant death are a terrible loss and traumatic for any mother and family. Women with a previous infant death need additional support and advice concerning any subsequent pregnancies,” said Philip Steer, editor in chief of Oxford, UK-based BJOG, in a statement. “Obesity and smoking in pregnancy are known risk factors for stillbirth and advice needs to be centered on pre-conception health so a woman can be as healthy as possible before, during and after pregnancy.”

To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net.

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

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