In the UK, 1 in every 250 pregnancies ends in stillbirth - when a baby dies after 24 weeks gestation. This rate is estimated to almost double in the most deprived parts of the nation compared to the most affluent areas, but research has struggled to explain the difference as studies aren’t always able to adjust for other stillbirth risk factors linked to deprivation, such as cigarette smoking, education, housing, ethnicity, migrant status and social stress.
What our researchers found
Scientists from Tommy’s Maternal and Fetal Health Research Centre at the University of Manchester studied more than 1,000 births across 41 UK hospitals between 2014 and 2016. They combined information typically used to measure stillbirth risk with an interviewer-led questionnaire about mothers’ behaviour and social characteristics, taking into account other factors like smoking that have muddied the waters in previous research, to see if and when stillbirth may have been avoidable.
Their findings, published today in the British Journal of Obstetrics & Gynecology, show that women from the most deprived socio-economic group were at almost triple (2.96x) the risk of stillbirth than those at the other end of the scale. Interestingly, this was a sudden change in the most deprived group rather than a gradual rise across the spectrum. Unemployed mothers were similarly more likely to have stillborn babies (2.85x higher risk).
High levels of perceived stress were shown to double the risk of stillbirth, independent of other social factors and pregnancy complications that can put pressure on mothers. The new study also found links between stillbirth and abusive relationships; women who declined to answer a question about domestic abuse were over 4x more likely to experience stillbirth – but those who answered yes did not have a higher risk, possibly because their willingness to disclose this information to researchers meant they’d also done so to other external parties who could then intervene to protect mother and baby.
How this affects families
London mum Louise Joines, 36, gave birth to stillborn son Gabriel in December 2017 after a physically healthy but psychologically stressful pregnancy; she had a busy job as a deputy head teacher and 2 children at home with no support from the baby’s father. Despite asking to see a mental health specialist during the pregnancy, Louise was not referred and wonders now if that help could have saved her baby.