Stillbirth
The birth of a child is one of the great joys of life for families, but tragically each year more than 2,100 Australian babies are stillborn. This significant loss of our youngest lives is more than our national road toll, 1,580. Incredibly around 20 per cent of stillbirths could be prevented, but there has been no improvement for two decades. New strategies are needed to reduce the rate of stillbirth, for families and their babies.
Hudson Institute researchers have made it a priority to reduce stillbirths by understanding the causes, identifying high risk mothers and closing the gap between scientific knowledge and clinical practice.
What is stillbirth?
Stillbirth is when a baby dies in the womb after 20 weeks pregnancy. If a developing baby dies before 20 weeks gestation, it is called a miscarriage. If the length of the pregnancy is not clear, it is designated as a stillbirth if a baby weighs more than 400 grams.
Stillbirth is further defined by the pregnancy length
- Early stillbirth is 20-27 weeks
- Late stillbirth is 28-36 weeks
- After 37 weeks is called term stillbirth.
What causes stillbirth?
The known causes of stillbirth are
- A genetic or physical birth defect in the developing baby
- An infection in the mother or one that affects the developing baby
- Maternal health conditions including hypertension, diabetes, gestational diabetes, and pre-eclampsia
- Complications with carrying multiples eg; twins, triplets
- Placental issues. The placenta is the organ that provides a developing baby with oxygen and nutrients.
Umbilical cord issues are more likely in late pregnancy and include the cord becoming knotted, compressed or ruptured. This prevents a developing baby receiving enough oxygen to survive.
- Hypoxia, when the baby doesn’t get enough oxygen
- Spontaneous preterm birth
- About 10 per cent of stillbirths are unexplained.
What are stillbirth risks?
Stillbirth can happen to anyone however there are risk factors that been linked to stillbirth. These include
- Smoking, drinking alcohol or use illegal drugs
- Having your first baby
- Taking prescription painkillers
- Having a low or high body mass index (underweight or overweight)
- Having an existing medical condition, eg; epilepsy, high blood pressure or diabetes
- Being under 18 years or more than 35 years
- Having a previous stillbirth
- Being more than 41 weeks pregnant
- Conception through IVF or other fertility treatments
- No or limited medical care
- Disadvantaged eg; lower socio-economic
- Aboriginal and Torres Strait Islander women
- Migrant or Refugee Background.
Scientists reducing stillbirth
Hudson Institute research has shown that the length of a pregnancy is not always the universal 40 weeks that has been widely accepted. Instead, pregnancy length differs, based on a mother’s ethnic background or country of origin. The 2017 study found that
- Pregnant women born in South Asia, the Middle East and Africa are more likely to have a late-term stillbirth (after 37 weeks) than women born in Australian, New Zealand and Southeast Asia
- The average natural onset of labour occurred earlier in women born in South Asia, at 39 weeks, compared to 40 weeks for women born in Australia or New Zealand
- The placenta ‘ages’ more rapidly in some ethnic groups, leading to increased risk of stillbirth in the term period overall.
Stillbirth research at Hudson Institute
Our stillbirth research program combines population-based and clinical epidemiological studies with biological science to inform the standard clinical care. The program aim is to reduce the rate of stillbirth in Australia and support improvements in clinical care.
Following our scientist’s discovery that South Asian mothers are at an increased risk of stillbirth, new clinical care guidelines introduced at Monash Health halved the rate of stillbirth at term for South Asian women. Our researchers are now leading the roll-out, evaluation and expansion of new guidelines to support health services across Australia that will reduce stillbirth.
In addition, for the first time they are exploring the endometrium and its potential roll as an early driver of stillbirth.
Reducing stillbirth in Victoria
Dr Davies-Tuck’s research aims to reduce Australian stillbirth by identifying and exploring the reasons behind stillbirth as well as determining the effectiveness of stillbirth prevention strategies. Dr Davies-Tuck. Dr Davies-Tuck’s research combines large population-based datasets, epidemiological studies and basic science.
Understanding drivers of stillbirth to inform prevention
Every day six women in Australia has a stillborn baby. This number hasn’t changed very much over the past 20 years. Together with the collaborators within the Hudson Institute, the Department of Obstetrics and Gynaecology, Monash University, Safer Care Victoria at the Department of Health and the Australian Stillbirth Centre for Research Excellence (Stillbirth CRE), we have a range of projects on offer exploring drivers for stillbirth in Victoria and improving care for women for tomorrow.
Understanding and preventing stillbirth – early drivers of stillbirth
This study will reveal the foundation of placental issues in stillbirth, opening up completely new directions of stillbirth research and prevention. The majority of stillbirths occur in the perterm period. For the first time, Dr Miranda Davies-Tuck is investigating the endometrial environment in women who experience preterm birth or preterm stillbirth, including the critical steps that occur prior to the placenta forming at the time of conception. This work will uncover the early drivers of stillbirth and possible early targets for therapies to optimise implantion or support fetal development.
Stillbirth collaborators
Support for families
Our scientists cannot provide medical advice. If you would like to find out more information about miscarriage and stillbirth, please visit Stillbirth Centre for Research Excellence.
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