Stillbirth: Causes And Risk Factors

Stillbirth: Causes And Risk Factors

By Dr. Pankhuri Gautam, Experienced Gynecologist

Stillbirth is a heartbreaking moment when a child passes away in the womb, deeply impacting families and expecting mothers alike. Stillbirth refers to the tragic death of a baby at or after 20 weeks of pregnancy due to some reasons.

According to the World Health Organization (WHO), nearly 2 million babies are stillborn each year, equating to one every 16 seconds. In India, the rate is notably high, highlighting the urgent need for increased awareness and preventive measures.

As an obstetrician deeply committed to maternal health, I, Dr Pankhuri Gautam, understand the emotions and uncertainties. Stillbirth has causes such as medical conditions, including placental issues and infections, to lifestyle factors like smoking and poor nutrition. Recognising these factors early can help in prevention and proactive management during pregnancy.

Through this blog, I aim to provide you with information, help you understand the complexities of stillbirth, and encourage you to take proactive steps to safeguard your pregnancy journey confidently.

What Is Stillbirth?

A stillbirth is when a foetus dies after the 20th week of pregnancy. Many people imagine a stillbirth as a single moment when a baby is born with no heartbeat, but most stillbirths happen in the uterus. Although it can occur during labour, this is rare. 

Types of Stillbirth:

There are two primary types of stillbirth:

1. Antepartum Stillbirth: This occurs before labour begins, often due to issues like placental problems or foetal abnormalities.

2. Intrapartum Stillbirth: This happens during labour and delivery, typically resulting from complications such as umbilical cord accidents or labour-related issues.

Stillbirth is a jarring pregnancy loss, similar to a miscarriage. While stillbirth involves foetal death after week 20, a miscarriage consists of the foetus passing away before week 20. 

Symptoms Of Stillbirth

Recognising the symptoms of stillbirth is crucial for timely intervention and medical support. Here are some common signs that may indicate a stillbirth:

 

• Absence of Foetal Movements: One of the most common signs of stillbirth is the sudden absence of foetal movements. Expectant mothers often notice a significant decrease or complete stop in the baby's usual kicks and movements. If you experience this, it is crucial to contact your healthcare provider immediately.
   

• No Foetal Heartbeat Detected During Check-ups: Your healthcare provider monitors the baby's heartbeat during routine prenatal check-ups. If a heartbeat is not detected, it may indicate a stillbirth. An ultrasound is usually performed to confirm the diagnosis.
   

• Decrease or Absence of Pregnancy Symptoms: A noticeable decrease or complete absence of typical pregnancy symptoms, such as morning sickness, breast tenderness, and weight gain, can be an alarming sign of stillbirth.
   

• Vaginal Bleeding or Spotting: Unexplained vaginal bleeding or spotting can be a symptom of stillbirth. While some bleeding can occur in healthy pregnancies, it is essential to consult with your healthcare provider to rule out any complications.

Causes Of Stillbirth

Medical Conditions:

Placental Problems:

• Placental Abruption: Occurs when the placenta detaches from the uterus before delivery, cutting off the baby's oxygen and nutrient supply.
• Placenta Previa: The placenta covers the cervix, causing severe bleeding and complications that can lead to stillbirth.

Infections:

• Bacterial Infections: Infections like Group B Streptococcus can infect the womb and cause stillbirth.
• Viral Infections: Viruses such as cytomegalovirus (CMV) and herpes can cross the placenta and harm the baby.

Foetal Abnormalities:

• Genetic Disorders: Conditions like Down syndrome or other chromosomal abnormalities can result in stillbirth.
• Congenital Malformations: Structural issues in the baby’s organs or body parts can lead to stillbirth.

Chronic Maternal Conditions:

• Diabetes: Poorly managed diabetes can cause complications that result in stillbirth.
• Hypertension: High blood pressure can restrict blood flow to the baby, increasing the risk of stillbirth.
• Thyroid Disorders: Both overactive and underactive thyroid conditions can negatively impact pregnancy outcomes.

Pre-eclampsia and Eclampsia:

• These conditions involve high blood pressure and can lead to severe complications, including stillbirth.

Lifestyle Factors:

• Smoking and Substance Abuse: Smoking, drugs, and alcohol during pregnancy increase the risk of stillbirth. These substances can restrict oxygen and nutrients to the baby, causing developmental issues and complications like placental abruption and low birth weight.

• Poor Nutrition and Diet: A lack of essential nutrients negatively affects the baby's development, increasing the risk of stillbirth. Proper nutrition, including adequate vitamins and minerals, supports healthy foetal growth and reduces complications.

• Lack of Prenatal Care: Regular prenatal check-ups are crucial for detecting and managing potential issues early. Without prenatal care, conditions like high blood pressure, diabetes, and infections can go unnoticed, raising the risk of stillbirth.

External Factors:

• Accidents and Trauma: Physical trauma or accidents during pregnancy, such as falls or car accidents, can cause harm to the baby, leading to stillbirth due to complications like placental abruption.
• Environmental Exposures: Exposure to toxins and pollutants, such as pesticides, heavy metals, air pollution, and secondhand smoke, can negatively impact foetal development and increase the risk of stillbirth.

Risk Factors For Stillbirth

Maternal Age:

• Teenage Pregnancy: Pregnant teenagers face a higher risk of complications, including stillbirth, due to various factors such as socioeconomic status and biological immaturity.
• Advanced Maternal Age: Women over the age of 35 are at a higher risk of stillbirth due to increased chances of chromosomal abnormalities and other pregnancy-related complications.

Previous Pregnancy Complications:

• History of Stillbirth or Miscarriage: Women who have experienced a previous stillbirth or multiple miscarriages are at a higher risk of stillbirth in subsequent pregnancies.
• Multiple Pregnancies: Carrying twins, triplets, or more increases the risk of complications, including stillbirth, due to shared resources and space in the womb.

Socioeconomic Factors:

• Access to Healthcare: Limited access to quality prenatal care can lead to undetected complications and increase the risk of stillbirth.
• Educational Level: Lower educational levels are often associated with a lack of knowledge about pregnancy health and fewer resources to manage potential complications.
• Income and Living Conditions: Poor living conditions and low income can contribute to stress, inadequate nutrition, and lack of healthcare, all of which increase the risk of stillbirth.

Diagnosis And Prevention from Stillbirth

Diagnosis:

1. Ultrasound and Foetal Heart Rate Monitoring: 

Ultrasound is the primary tool for diagnosing stillbirth. It can detect the absence of fetal heartbeat and movement, providing a clear picture of the baby’s health. Regular foetal heart rate monitoring during prenatal visits also helps in the early detection of any issues.

2. Amniocentesis or Blood Tests: 

In some cases, additional diagnostic tests, such as amniocentesis or specific blood tests, may be conducted to identify underlying causes, such as genetic disorders or infections.

Prevention:

• Regular Check-ups: Consistent prenatal visits are crucial for monitoring the health of both mother and baby. These visits help detect potential problems early, allowing for timely interventions.
• Diet and Nutrition: Maintain a balanced diet rich in essential nutrients. Adjust your diet to meet the increased caloric and nutritional needs during pregnancy. Avoid foods that may pose a risk of foodborne illness.
• Report Symptoms Immediately: Contact a healthcare provider immediately if you experience symptoms like stomach pain or vaginal bleeding during pregnancy. Prompt medical attention can help manage potential complications effectively.

Conclusion

Maintaining awareness about stillbirth is crucial for expectant mothers. Understanding its causes, symptoms, and risk factors can significantly impact the prevention and outcomes of pregnancies. Seeking immediate medical advice is essential if you notice any signs of potential complications.

As a seasoned obstetrician and top gynaecologist in Jaipur, I, Dr Pankhuri Gautam, am committed to providing expert advice and personalised care. Our dedicated team offers comprehensive evaluations and customised treatment plans to ensure the best possible outcomes for your pregnancy.

Contact us today to make an appointment and receive the expert care you deserve for your pregnancy.