Stillbirth, by definition, occurs after the 20th week of pregnancy. At that point chances are the mother has felt tiny flutters, kicks and movements indicating life. By 20 weeks and beyond most couples have seen the ultrasound images of their baby and often the images are much more vivid than earlier in pregnancy. They see a little human being with hands, feet, legs, arms, and facial features, moving around the uterus, sometimes even sucking his or her thumb.
The loss of a pregnancy is devastating no matter when it occurs but a stillbirth is particularly so. Many couples find this type of loss more profound than miscarriage as the pregnancy is more advanced and results in a birth, which is difficult in and of itself.
Stillbirth in the United States affects about one out of every 160 births. The number of babies who die in utero after 20 weeks’ gestation is about 24.000 each year. Reproductive technology has advanced in the past three decades, as has prenatal care, which reduces the number of late pregnancies (28-36 weeks) and term (37-term) stillbirths experienced today. The number of early term (20-27 weeks) stillbirths remains unchanged.
Causes of Stillbirth
In 50% of stillbirths there is no known cause. These are “unexplained stillbirths” For the remaining half, some of the known causes of stillbirth follow:
- Birth defects, both chromosomal and non-chromosomal
- Placental problems. The placenta provides the developing fetus with nourishment. In the case of placental abruption, the placenta separates from the wall of the uterus too soon.
- Umbilical cord problems. The cord becomes prolapsed, exiting the vagina before the baby and cutting off baby’s oxygen supply before they can breathe on their own. In some cases the cord wraps around the baby’s neck or a limb.
- Chronic and pregnancy induced conditions of the mother, such as hypertension, diabetes, preeclampsia and pregnancy-related high blood pressure.
- Intrauterine Growth Restriction (IUGR) is a condition restricting blood flow to the developing fetus and undermining healthy development. Causes of IUGR are placental problems, high blood pressure, infections in the mother, smoking and alcohol abuse.
- Lack of nutrition.
- Infections and certain viruses during pregnancy. Most commonly, streptococcus B, E. coli, Haemophilus influenza and chlamydia, as well as some other uncommon infections.
- Exposure to certain environmental toxins such as carbon monoxide and pesticides.
- A history of blood clotting disorders such as thrombosis, thrombophlebitis and pulmonary embolism.
- Pregnancy with multiples, such as triplets or quadruplets.
- Mother under the age of 15 or over the age of 35.
- Obesity
Does Fertility Treatment Put My Baby at Higher Risk?
While some studies in the last several decades point to a connection between infertility treatment and stillbirth, this isn’t accurate. For couples seeking IVF and other treatments for infertility it’s important to understand that some of the causes of infertility also increase your risk for stillbirth (i.e. advanced maternal age, obesity and lifestyle). There is no direct connection between fertility treatment and stillbirth.
Ways to Reduce the Risk of Stillbirth
While half of all stillbirths in the U.S. remain a mystery, there are some measures you can take to reduce your risk and promote fetal development.
- Lifestyle changes such as stopping smoking, alcohol consumption and any other illicit behaviors are beneficial to you and your developing baby. Optimally, you should call a halt to all of these behaviors prior to becoming pregnant. Ask your physician for ways to better your lifestyle.
- Maintain a healthy weight. While this can be difficult in the midst of both fertility treatment and pregnancy, it is beneficial to you and your baby. By maintaining a healthy weight, you avoid certain conditions like hypertension and diabetes which pose a risk for stillbirth. Try your best to go into your treatment at a healthy BMI.
- Sleep on your left side in your third trimester. This sounds simple enough and prevents undue pressure on your inferior vena cava, a large vein that carries blood to your heart. While studies show conflicting evidence regarding side sleeping, back sleeping and right versus left side, it’s such a small ask that why not?
- Never miss your OB appointments. Your doctor knows when something appears amiss and can catch any particular issues early on.
- For IVF opt for preimplantation genetic diagnosis to rule out any abnormalities with the embryo before implantation.
Prenatal Care is Vital
Most women who experience a stillbirth go on to have a healthy next pregnancy. If a chromosome abnormality or an umbilical cord problem caused the stillbirth the odds of a recurrence are extremely small. If the cause was genetic or a chronic condition of the mother the odds are slightly higher for a recurrence. On average your next pregnancy has a higher than 90% chance of success.
One of the best ways to reduce your risk of stillbirth is through prenatal care. At LA IVF we are by your side throughout the entire process, recommending you to obstetrical care only once we know all is well. If you have concerns about your fertility and potential risk for stillbirth contact LA IVF.
