Stillbirth can have multiple possible causes, and in many cases the exact reason remains unknown even after evaluation. Below is a concise overview of common contributors, how they are identified, and how care teams approach the situation. Key potential causes
- Placental problems: Insufficient blood flow to the fetus, placental abruption (placenta detaches from the uterus too early), or other placental abnormalities.
- Fetal genetic or congenital conditions: Chromosomal abnormalities or major birth defects that affect development.
- Infections: Infections in the mother, placenta, or fetus can contribute to fetal death.
- Umbilical cord issues: Knots, compression, or other cord problems that reduce oxygen and nutrients.
- Pregnancy and labor complications: Preterm labor, multiple gestation (twins, triplets, etc.), or complications arising during labor.
- Maternal health conditions: Chronic conditions such as high blood pressure, diabetes, autoimmune diseases, or severe obesity can increase risk.
- Medical conditions during pregnancy: Preexisting or pregnancy-induced conditions that affect the placenta or fetus.
- Unknown or multifactorial causes: In some cases, no single cause is identified, but a combination of risk factors may be involved.
What is known about timing
- Early pregnancy: Placental and infection-related factors, plus fetal genetic issues, are more commonly implicated.
- Late pregnancy and term: Placental insufficiency, umbilical cord problems, and maternal conditions like high blood pressure are more often involved.
How causes are investigated (general approach)
- Medical history and risk assessment: Review of maternal health, pregnancy history, and any risk factors.
- Ultrasound and fetal monitoring: Assess fetal growth, movement, and well-being; monitor the placenta and umbilical cord.
- Blood tests and genetic testing: Screen for infections, metabolic issues, and genetic conditions; may include prenatal testing or postnatal (after birth) analysis of the baby.
- Placental examination: If feasible, the placenta may be examined after birth to look for abnormalities.
- Additional testing: In some cases, autopsy of the baby or comprehensive postmortem investigations can help determine cause.
Important notes
- In many cases, a stillbirth is due to more than one factor, and sometimes the exact cause cannot be determined even after thorough testing.
- Understanding potential causes can help guide future pregnancies and inform risk assessment, counseling, and management in subsequent pregnancies.
If you or someone you know is facing this situation or seeking information for planning future pregnancies, consider consulting a perinatal specialist or a maternal-fetal medicine expert. They can provide personalized information, support, and resources based on the specific medical history and circumstances.
