About Birth

Stillbirths in U.S. can be prevented

By Marissa Cevallos
April 14, 2011

Stillborn births aren’t declining very much.  More than 2 million babies are stillborn worldwide every year, and almost 26,000 of them are in the U.S., reported researchers in a comprehensive series on fetal deaths in The Lancet.

Poor medical care is a big factor in areas like sub-Saharan Africa and South Asia, where three-quarters of the deaths occur.

But in high-income countries like the U.S. -- where 1 in 200 babies who reach 22 weeks dies -- researchers found a wide range of possible causes.  As it turns out, many of the preventable risks researchers found are the same ones that put adults at risk for diabetes and heart disease.

Let’s take a look behind the numbers.

Researchers analyzed 96 studies of stillbirth in high-income countries and calculated how different risk factors would affect the countries with the highest stillbirth rate (U.S., Australia, Canada, Netherlands and the UK).

They found that in high-income countries, obesity is the biggest risk factor for a stillbirth.  About 4,000 stillbirths in the U.S. may be attributed to being overweight, they calculated.  Putting on weight between pregnancies, even if you weren’t overweight to begin with, will increase the odds of a stillbirth too.

Heavy smoking nearly doubles the odds of a stillbirth—some 1,097 deaths may be attributed to mothers smoking more than 10 cigarettes per day.  And waiting until later in life to have a baby may increase the odds of a stillbirth by 65% -- the researchers calculated 1,116 deaths could be related to giving birth after age 35.

Researchers write in an accompanying paper:

“In high-income countries, there is an expectation that every pregnancy will end with the birth of a healthy baby.  Yet about one baby out of every 200 (who reaches 22 weeks' gestation or more) is stillborn.  Public perception is that stillbirths are a thing of the past, but these are not rare events.  The effect of a stillbirth on parents is devastating and long term: to many of these parents the death of their baby before birth is no less a death than is the death of any other child…families are often left with intense grief and damaging psychological and social problems for many years.”

Socioeconomic status, while harder to measure, is also associated with higher odds of stillbirth.  The researchers found disparities in race within the U.S.—African American women are more likely to have a stillbirth than white women, a phenomenon that persists even after socioeconomic status and other factors are accounted for.  Researchers have struggled to explain the disparity.

But many of the factors that people can change—obesity and smoking, for example—are the same as those that change a person’s risk for many other diseases.  Focusing on healthier diets, exercise and less smoking would have health benefits for babies and adults.

Marissa Cevallos
Freelance health writer for the Los Angeles Times
Charleston, West Virginia Area
University of California, Santa Cruz and California Institute of Technology