Stillbirth

Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can often result in the feeling of guilt or grief in the mother. The term is in contrast to miscarriage, which is an early pregnancy loss, and Sudden Infant Death Syndrome, where the baby dies a short time after being born alive. Often the cause is unknown. Causes may include pregnancy complications such as pre-eclampsia and birth complications, problems with the placenta or umbilical cord, birth defects, infections such as malaria and syphilis, and poor health in the mother. Risk factors include a mother's age over 35, smoking, drug use, use of assisted reproductive technology, and first pregnancy. Stillbirth may be suspected when no fetal movement is felt. Confirmation is by ultrasound. Worldwide prevention of most stillbirths is possible with improved health systems. Around half of stillbirths occur during childbirth, with this being more common in the developing than developed world. Otherwise, depending on how far along the pregnancy is, medications may be used to start labor or a type of surgery known as dilation and evacuation may be carried out. Following a stillbirth, people are at higher risk of another one; however, most subsequent pregnancies do not have similar problems. Depression, financial loss, and family breakdown are known complications. Worldwide in 2019, there were an estimated 2.0 million stillbirths that occurred after 28 weeks of pregnancy (about 1 for every 72 births). They occur most commonly in low income settings, particularly the Middle East and Sub-Saharan Africa. In the United States, for every 167 births there is one stillbirth. Stillbirth rates have declined, though more slowly since the 2000s. As of 2016, there is no international classification system for stillbirth causes. The causes of a large percentage of stillbirths is unknown, even in cases where extensive testing and an autopsy have been performed.