Extra support needed in any pregnancy after a stillbirth, say researchers

Women and birthing people who have experienced a stillbirth are at higher risk of another even if they have also had a baby who survived, and should therefore be offered extra monitoring during any future pregnancy, say researchers.

A study led by Professor Alex Heazell at Tommy’s National Maternal and Fetal Health Research Centre analysed data from more than 1.3 million births, including almost 9,000 stillbirths.

The researchers found that women whose first pregnancy sadly ended in a stillbirth but who went on to have a live baby in their second pregnancy remained at higher-than-normal risk of a stillbirth in their third pregnancy.

For those whose first pregnancy resulted in a livebirth but their second in a stillbirth, the risk of stillbirth in a third pregnancy was increased further.

The highest risk of stillbirth in a third pregnancy was among women whose first and second pregnancies had ended with a stillbirth.

The authors found women were more likely to have a further stillbirth even if their previous loss was not connected with a medical condition such as gestational diabetes or hypertension (high blood pressure), or with a genetic issue affecting their baby.

They conclude: “[This] increased risk...provides a rationale for providing additional antenatal surveillance and directed management in all pregnancies after stillbirth, rather than solely the immediate pregnancy after stillbirth.”

They also call for more research into the causes of stillbirth.

Professor Heazell runs the Rainbow Clinic, part of the Tommy’s Maternal and Fetal Research Health Centre at St Mary’s Hospital in Manchester, which provides specialist care for women in pregnancy after stillbirth or neonatal death. 

He said: 

“This was the first study analysing the risk of stillbirth for women in their third pregnancy who have suffered a stillbirth in either their first or second pregnancy.

“Our findings suggest that, even if they have experienced one pregnancy which resulted in a live birth, women who have suffered a stillbirth previously are more likely to experience another.

“That’s why we are recommending that women who have had a stillbirth should be offered extra checks and monitoring throughout any future pregnancy.”

Kate Davies, Research, Policy and Information Director for Tommy’s, said: 

“We know that any pregnancy after stillbirth can be a very anxious time and many women and birthing people may need extra support. 

“Unfortunately, currently services for women and birthing people who have experienced a stillbirth vary widely across the UK.

“We believe that everyone who has been through the trauma of a stillbirth should have access to the best possible care, including additional checks and monitoring such as those provided at our Tommy’s Rainbow Clinics, which is why we’ve been working to roll this model of care out across the country.”

Risk of stillbirth and adverse pregnancy outcomes in a third pregnancy when an earlier pregnancy has ended in stillbirth