Stillbirth in first pregnancy ups risk on second time

Women who have experienced a stillbirth have up to a four-fold increased risk of stillbirth in a second pregnancy compared to those who had an initial live birth, says a new study led by an Indian-British scientist.

Stillbirth is still a major public health concern despite rates falling across high income countries. Stillbirth refers to foetal death at more than 20 weeks' gestation or a birth weight of at least 400g.

"Stillbirth is one of the most common adverse obstetric outcomes and a traumatic experience for parents," explained India-born Sohinee Bhattacharya from the University of Aberdeen, Scotland.

"Couples who have experienced a stillbirth need to understand why it happened and want to know the risk for future pregnancies," Bhattacharya noted.

They undertook systematic review and meta-analysis to examine the link between stillbirth in an initial pregnancy and risk of stillbirth in a subsequent pregnancy.

The team analysed 13 cohort and three case-control studies from high-income countries. Data was collected for 3,412,079 women out of which 3,387,538 (99.3 percent) had a previous live birth and 24,541 (0.7 percent) had a stillbirth in an initial pregnancy.

Stillbirths occurred in the subsequent pregnancy for 14,283 women: 606 of 24,541 (2.5 percent) in women with a history of stillbirth and 13,677 of 3,387,538 (0.4 percent) in women with no history.

Women who had a stillbirth in an initial pregnancy had a nearly fivefold increased risk of stillbirth in a second pregnancy. This risk is higher than stillbirth linked with medical conditions such as diabetes or hypertension.

"Pregnancies should be closely monitored, and antenatal interventions and care be offered at the first sign of increased risk of distress or danger," the authors said.

The study appeared in The BMJ.