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Updated: May 24, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

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Published on: June 6, 2020

Stillbirth risk in a second pregnancy.

Adrienne Gordon1, Camille Raynes-Greenow, Kevin McGeechan

  • 1Department of Neonatal Medicine, Royal Prince Alfred Hospital, Sydney School of Public Health and Sydney Medical School, University of Sydney, New South Wales, Australia. adrienne.gordon@email.cs.nsw.gov.au

Obstetrics and Gynecology
|February 23, 2012
PubMed
Summary

A prior pregnancy resulting in a small-for-gestational age (SGA) or preterm birth significantly elevates stillbirth risk in a subsequent pregnancy. Previous stillbirth shows a nonsignificant association, highlighting the need for enhanced surveillance.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Epidemiology
  • Reproductive Health

Background:

  • Previous adverse pregnancy outcomes, including stillbirth, preterm birth, and small-for-gestational age (SGA) neonates, may indicate increased risk in subsequent pregnancies.
  • Understanding these risks is crucial for targeted interventions and improved maternal-fetal outcomes.

Purpose of the Study:

  • To quantify the association between adverse outcomes in a first pregnancy (stillbirth, preterm birth, SGA) and the risk of stillbirth in a second pregnancy.
  • To identify specific risk factors that may necessitate closer monitoring in future pregnancies.

Main Methods:

  • Population-based cohort study utilizing linked birth and death records in New South Wales, Australia (2002-2006).
  • Inclusion of singleton births from first pregnancies linked to second pregnancies.
  • Crude and adjusted hazard ratios calculated using proportional hazards models to estimate risks.

Main Results:

  • Delivery of a small-for-gestational age (SGA) newborn in the first pregnancy was associated with a 1.73-fold increased risk of stillbirth in the second pregnancy.
  • This risk escalated to a 5.65-fold increase if the first pregnancy involved both prematurity and SGA.
  • A previous stillbirth showed a nonsignificant association with stillbirth in the second pregnancy (hazard ratio 2.03).

Conclusions:

  • Delivering an SGA and preterm neonate in a first pregnancy poses a greater risk for stillbirth in a subsequent pregnancy compared to a previous stillbirth.
  • These findings underscore the importance of enhanced surveillance in pregnancies following an SGA or preterm birth.
  • Further research is recommended to investigate common underlying etiological factors for stillbirth, preterm birth, and SGA.