Every day in Australia six babies are stillborn.
There has been little change in the rate of stillbirth over the past three decades and the causes are still not well understood.
Stillbirth is a tragedy no one wants to contemplate—especially when they are expecting a baby. For some, the thought of losing a child can become an overwhelming fear.
But, thanks to recent research, we now know there are evidence-based modifiable risk factors and it is important for expectant parents to be aware of these. If you are understand the risks you can take preventative measures.
So what exactly is stillbirth? What causes it? Who is at risk? And what are the evidence-based preventative measures can you take to lower the risk?
What is stillbirth?
Stillbirth is the loss of a baby from 20 weeks’ gestation or 400g of body weight (where gestation is unknown).
What causes stillbirth?
There is still a lot we do not know about the causes of stillbirth and about 16.6 per cent of stillbirths remain unexplained . The major known causes of stillbirth are:
This is when there’s a problem with the baby’s development, starting from conception or early pregnancy. Congenital anomalies include chromosomal problems and issues with the development of major organs such as the heart, brain, spinal cord or kidneys.
The birth of a preterm baby can sometimes result in the baby being too immature to survive and can result in a stillbirth.
Maternal medical conditions
This is when a medical condition (such as diabetes), a surgical condition (such as appendicitis) or an injury, in the mother is the cause of stillbirth.
Perinatal conditions mostly commonly linked to stillbirth are associated with the placenta.
If the placenta isn’t functioning properly the baby will not be nourished and stillbirth can occur.
Placental abruption is when there’s bleeding between the placenta and the uterine wall. This can reduce blood supply to the fetus and is a common cause of stillbirth.
Infections associated with stillbirth include parvovirus, rubella, listeria monocytogenes, toxoplasmosis and group B streptococcus.
High blood pressure is associated with stillbirth, whether it is an existing condition or associated with the pregnancy. High blood pressure is linked to poor placenta function and fetal growth restriction. Blood pressure is frequently monitored during pregnancy.
Acute or chronic hypoxia—deprivation of oxygen.
Potential risk factors for stillbirth may be:
- Advanced maternal age (considered to be more than 35 years)
- Pre-pregnancy obesity
- Smoking, drug-taking, and alcohol consumption
- Gestational diabetes
- High blood pressure (hypertension)
- Congenital anomalies
- Premature birth (babies that are too immature may be stillborn)
- Placenta or cord problems
- First pregnancy
- Fetal growth restriction
- Maternal medical conditions
- Congenitally acquired infections
- Multiple gestation
Stillbirth preventative measures
In some cases, unfortunately, we don’t always know the reasons a baby is stillborn in an otherwise healthy pregnancy.
But there are known evidence-based modifiable risk factors and it is important to arm expectant parents with information about these so they may be able to reduce the risk of stillbirth.
The University of Queensland’s Stillbirth Centre of Research Excellence has created the Safer Baby Bundle which offers parents five inventions that can lower the risk of stillbirth
5 ways to reduce the risk of stillbirth
- Quit Smoking. Smoking in pregnancy is one of the main causes of stillbirth and is also linked to other complications such as preterm birth. Ask your pregnancy health care provider for support to quit smoking or stay away from secondhand smoke.
- Growing Matters. Fetal Growth Restriction (FGR) is an important risk factor for stillbirth. It is important that you attend all your pregnancy care appointments as your risk for FGR will be assessed in early pregnancy and your baby’s rate of growth will be measured.
- Movements Matter. Understanding your baby’s pattern of movement is an important way to tell if they are well. There are no set number of movements per day to count, but it is important to learn what is normal for your baby. You will start to feel your baby move between weeks 16 and 24 and you’ll continue to feel them move right up until birth (even during labour). If you are concerned about a change in your baby’s movement, contact you health care provider immediately.
- Sleep on your side. Research has shown that going to sleep on your side from 28 weeks of pregnancy can halve your risk of stillbirth, compared with going to sleep on your back. Sleeping on your back can reduce blood flow to your uterus and oxygen flow to your baby. It’s normal to move during sleep so don’t panic if you wake up on your back, just remember to go to sleep on your side (left or right) and if you do wake up on your back, roll over to your side.
- Timing of birth. All pregnancies have an optimal time of birth. If your pregnancy is healthy and progressing normal then it is best to wait for labour to start on its own. If a planned birth is needed (via caesarean or induction) then it is best to plan it as close to 40 weeks as possible. Talk to your health care professional about the safest time to have your baby.
Hopefully with increased awareness of the risk factors and preventative measures plus increased funding for research into stillbirth, we will soon see the rate of stillbirth decline.
– written with information from the Stillbirth Foundation Australia.
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