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Risk of repeat stillbirth higher: study

Risk of repeat stillbirth higher: study
Photo: Risk of repeat stillbirth higher: study
Researchers say pre-pregnancy counselling services should be provided to women who had a stillbirth, as well as advice on changing lifestyle factors.

Chances of having another stillbirth are four times higher for women who had a stillbirth before, says a study of millions of pregnant women, including Australians.

Stillbirth rates have declined in recent years, but experts say it remains a "common and traumatic" experience for many parents.

Researchers from the University of Aberdeen collected data from several studies conducted in "high-income countries" - including Australia, UK, US, Denmark, Israel and the Netherlands.

Data was collected from about 3.4 million women who had previously given birth and were pregnant again, of whom 24,541 had experienced a stillbirth.
Stillbirths occurred in a subsequent pregnancy for 14,283 women - 606 of whom had had an initial stillbirth - giving a 2.5 per cent risk of a repeat stillbirth.

There were 13,677 stillbirths among the almost 3.4 million other women with no history of stillbirth, giving a 0.4 per cent risk.

The researchers adjusted the figures for factors such as maternal age, maternal smoking and level of deprivation, and the increased risk of a repeat stillbirth was found to be four times higher.

In a report published in the British Medical Journal, the research team argue that pre-pregnancy counselling services should be provided to women who had a stillbirth, as well as advice on changing lifestyle factors such as smoking and obesity, which are both linked to an increased risk of stillbirth.

Pregnancies should also be closely monitored, and antenatal interventions and care be offered at the first sign of increased risk of distress or danger, the report adds.

Dr Sohinee Bhattacharya, from the University of Aberdeen, said: "Stillbirth is one of the most common adverse obstetric outcomes and a traumatic experience for parents.

"Couples who have experienced a stillbirth need to understand why it happened and want to know the risk for future pregnancies."

Experts from St Mary's Hospital in Manchester echoed calls for additional care.

Clinical director Dr Alexander Heazell said: "The death of a child is a life-changing event that may occur with no warning signs or symptoms.

"Women can believe their body has let them down and also feel guilty that they had not protected their child or given their family another child.

"Parents recognise that the support they need in a subsequent pregnancy differs from that needed and received previously.

"Continuity of care by the same provider and additional ultrasound scans provide parents with reassurance that their concerns will be heard and deviations from a healthy pregnancy detected.

"However, even these interventions do not remove the anxiety associated with a late stillbirth because there are no thresholds to reach, no point at which a stillbirth can be ruled out.

"Rather than trying to prevent or hide anxiety, care in a service dedicated to parents with a history of stillbirth exposes parents to other families with similar experiences and emotions, avoids awkward questions and helps reduce feelings of isolation."

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