A stillbirth is a traumatizing experience and now researchers are saying that women who have successfully gotten pregnant again are four times likelier to experience a stillbirth again compared to those who had live births initially.

Across most of Europe, the number of stillbirths has gone down. In the UK, however, it remains a major public health issue, causing the country to rank 33rd out of 35 European countries with 3,286 stillborn in 2013. A stillbirth is defined as fetal death over 20 weeks of gestation or with birth weights of at least 400g.

In a study published in the journal The BMJ, researchers systematically reviewed and meta-analyzed data to assess the link between stillbirths in initial pregnancies and risks of stillbirths occurring in the subsequent pregnancies using information from three case-control and 13 cohort studies in high-income countries, like Sweden, Norway, the Netherlands, Israel, Denmark, the United States, Scotland and Australia.

"Stillbirth is one of the most common adverse obstetric outcomes," said Sohinee Bhattacharya, one of the authors for the study, adding that couples who underwent such a traumatic experience should know why it happened so they can understand the risks that future pregnancies bring.

Unfortunately, not enough information has been gathered to establish guidelines for clinical management to improve preventing stillbirths, until now.

Based on previous research analyzed by Bhattacharya and colleagues involving 3,412,079 women, of whom 24,541 previously had stillbirths for their initial pregnancies, stillbirths occurred in subsequent pregnancies for 14,283 women. Out of this number, 2.5 percent or 606 had histories of stillbirth.

Twelve of the studies analyzed had originally assessed stillbirth risk in second pregnancies. According to analysis, those who had stillbirths previously were almost five times more likely to have stillbirths in their second pregnancies. Risks are even higher when the mothers were diagnosed as having high blood pressure or diabetes.

When the results were adjusted for confounding factors, like the age of the mother; if the mother smoked; and smoking deprivation levels, risks remained fourfold higher.

When stillbirths are unexplained though, risks accompanying subsequent pregnancies were not reported as increasing because there was not enough evidence to come up with a conclusion.

As lifestyle factors play a role in increasing risks of subsequent stillbirth, the researchers point out that women should be given pre-pregnancy counseling to help them prepare better and do what they can to avoid another stillbirth.

Aside from Bhattacharya, Kathleen Lamont, Neil Scott and Gareth T. Jones also contributed to the study. All the authors were from the University of Aberdeen in the UK.

Photo: Jerry Lai | Flickr

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