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Subsequent pregnancy after stillbirth: obstetrical and medical risks
Keren Ofir1, Anat Kalter, Orit Moran
1Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Journal of Perinatal Medicine
|April 25, 2013
Summary
Women with a prior stillbirth face higher risks of repeat stillbirth and pregnancy complications, particularly if they have thrombophilia. Repeat stillbirths often occur preterm.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Background:
- Stillbirth is a significant adverse pregnancy outcome.
- Understanding risk factors for recurrent stillbirth is crucial for improved maternal and fetal outcomes.
- Placental and prothrombotic factors may influence pregnancy outcomes after stillbirth.
Purpose of the Study:
- To evaluate obstetric outcomes in women with a history of stillbirth.
- To assess the impact of placental and prothrombotic risk factors on subsequent pregnancies.
- To identify factors influencing stillbirth recurrence risk.
Main Methods:
- Retrospective review of obstetric outcomes in women with prior stillbirth.
- Data collected included fetal loss, stillbirth, complications, gestational age, birth weight, mode of delivery, thrombophilia, and medications.
- Placental stillbirth defined by abruption, IUGR, or placental infarcts; compared with controls.
Main Results:
- Repeat stillbirth occurred in 6.8% of subsequent pregnancies, significantly higher than controls (RR 22.2).
- Repeat stillbirths were predominantly preterm (<37 weeks).
- Prior placental stillbirth increased risk of intrauterine growth restriction (IUGR); all repeat stillbirths occurred in women with thrombophilia.
Conclusions:
- Women with prior stillbirth have increased risks of complications and recurrence.
- Concurrent thrombophilia significantly elevates the risk of stillbirth recurrence.
- Preterm delivery is common in recurrent stillbirth cases.
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