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Stillbirth
Stillbirth affects 1/200 pregnant women in New Zealand every year and is a tragedy for the women and their families (PMMRC 9th Annual report, 2015).
Modifiable risk factors for stillbirth (Lancet stillbirth series 2011 and 2015)
Smoking
Obesity
Inter-pregnancy weight gain (excessive weight gain in pregnancy plus post-partum weight retention)
Increased maternal age
SGA
Drug and alcohol abuse
From the Lancet Stillbirth series, the botton line for preventing this devastating adverse outcome is providing high quality risk selection and modification where possible early in the pregnancy, and then antenatal care with intervention as indicated. This article from the Lancet in 2011 has a very good summary:
Flenady V, Koopmans L, Middleton P, Froen JF, Smith GC, Gibbons K, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331-40. http://dx.doi.org/10.1016/S0140-6736(10)62233-7
Once a stilbirth has occured, what grieving familes need is support and information. A series of investigations are offered to attempt to elicit the cause- this can include postmortem, histology of the placenta, imaging, and blood tests. Social workers are involved to help with details of registering the birth and burial. This is the link to the support network in New Zealand for stillbirth: http://www.sands.org.nz/. It provides information on support networks for women and resources for clinicians.
