Stillbirth: A “Largely Unstudied” Problem

Pink ribbons across the country ensures that everyone knows that October is breast cancer awareness month, but less known it is also pregnancy and infant loss awareness month. Stillbirth is the term used to describe the loss of a pregnancy after the 20th week, due to “natural causes”. Stillbirths occur in 1 to 160 pregnancies in the Unites States every year.

Giving birth to a stillborn baby is a woman's worst nightmare. When it does happen, it's natural to want to understand why. Unfortunately, answers are rarely to be found . More than 70% of stillbirths are never explained. Doctors theorize that the majority of stillbirths probably have something to do with the placenta or umbilical cord not functioning correctly, chromosomal abnormalities, maternal or fetal infections, and maternal conditions such as HTN. Most often stillbirth is detected while the baby is in the mothers uterus, but sometimes not until labor is underway.

Encouragingly, the work of the physicians and scientists participating in the National Institute of Health’s: Stillbirth Collaborative Research Network (SCRN) is beginning to bear fruit. The August 2010 issue of the journal Obstetrics & Gynecology included an important article in which the SCRN investigators presented their “standardized method to assign probable and possible causes of death of stillbirths based on information routinely collected during prenatal care and the clinical evaluation of fetal death.” Rigorously defining and more accurately determining causes of fetal death will both facilitate research and have useful clinical implications. Accurately assigning a cause of fetal death is critically important for counseling grieving families. Before I read this article, I was unaware that the cause for most stillborn cases are unknown. But then again, I'm not surprised. Just based on the causes that have been identified, one would think that the physicians office would conduct an...