Śmierć płodu – Zapobieganie i profilaktyka

Śmierć płodu
Zapobieganie i profilaktyka

Śmierć płodu definiowana jest jako zgon dziecka po 20-24 tygodniu ciąży, przed lub podczas porodu, z częstością około 1 na 160-250 ciąż w krajach rozwiniętych. Globalnie dochodzi do około 2 milionów przypadków rocznie, z ponad 40% zgonów występujących podczas porodu, co podkreśla znaczenie wysokiej jakości opieki prenatalnej i okołoporodowej. Kluczowe czynniki ryzyka obejmują palenie tytoniu, otyłość (BMI >30), spożycie alkoholu, pozycję podczas snu (spanie na plecach po 28 tygodniu ciąży podwaja ryzyko), cukrzycę ciążową, nadciśnienie tętnicze, infekcje (w tym COVID-19), zaawansowany wiek matki, ciążę po terminie oraz ograniczenie wzrastania płodu. Profilaktyka opiera się na regularnych wizytach prenatalnych, monitorowaniu ruchów płodu (np. program Count the Kicks od 28 tygodnia), stosowaniu kwasu acetylosalicylowego w dawce 50-150 mg/dobę przed 16 tygodniem u kobiet z wysokim ryzykiem stanu przedrzucawkowego, a także na promowaniu zdrowego stylu życia i odpowiedniej pozycji do snu.

Definicja śmierci płodu i skala problemu

Śmierć płodu (ang. stillbirth) definiuje się jako zgon dziecka, który następuje po ukończeniu 20-24 tygodnia ciąży (w zależności od kraju), ale przed lub podczas porodu. W krajach rozwiniętych śmierć płodu dotyka około 1 na 160-250 ciąż, co przekłada się na około 21 000 przypadków rocznie w Stanach Zjednoczonych i ponad 2000 w Australii¹²³. Według Światowej Organizacji Zdrowia (WHO), na świecie co 16 sekund dochodzi do zgonu płodu, co daje szacunkową liczbę 2 milionów przypadków rocznie⁴. Szczególnie niepokojący jest fakt, że ponad 40% przypadków śmierci płodu występuje podczas porodu i większość z nich można byłoby zapobiec poprzez wysokiej jakości opiekę medyczną w okresie ciąży i porodu⁵.

Pomimo postępów w opiece prenatalnej, wskaźnik śmierci płodu w wielu krajach rozwiniętych, w tym w Stanach Zjednoczonych, obniżył się w ciągu ostatnich dwóch dekad jedynie o 0,4%, podczas gdy inne kraje osiągnęły znacznie lepsze wyniki⁶. Najnowsze badania sugerują, że około 25% przypadków śmierci płodu można zapobiec, co podkreśla pilną potrzebę skoncentrowania wysiłków na profilaktyce⁷⁸.

Czynniki ryzyka śmierci płodu

Zrozumienie czynników ryzyka jest kluczowe dla skutecznej profilaktyki śmierci płodu. Badania wskazują na różnorodne czynniki, które zwiększają ryzyko wystąpienia tego tragicznego zdarzenia⁹:

Czynniki modyfikowalne

Palenie tytoniu i używanie substancji psychoaktywnych – palenie podczas ciąży jest jedną z głównych przyczyn śmierci płodu i niesie ze sobą zwiększone ryzyko poronienia, porodu przedwczesnego oraz zespołu nagłej śmierci niemowląt¹⁰¹¹
Nadwaga i otyłość – kobiety z BMI powyżej 30 mają zwiększone ryzyko śmierci płodu¹²¹³
Spożywanie alkoholu – nawet niewielkie ilości alkoholu podczas ciąży mogą zwiększać ryzyko śmierci płodu¹⁴
Pozycja podczas snu – badania wykazały, że spanie na plecach po 28 tygodniu ciąży podwaja ryzyko śmierci płodu, prawdopodobnie z powodu zmniejszonego przepływu krwi i tlenu do dziecka¹⁵¹⁶
Krótki odstęp między ciążami¹⁷
Nieobecność na wizytach prenatalnych – regularne wizyty kontrolne umożliwiają wczesne wykrycie potencjalnych problemów¹⁸

Czynniki medyczne

Cukrzyca ciążowa – zaburzenia metabolizmu glukozy związane są z powikłaniami ciąży, w tym ze śmiercią płodu. Cukrzyca ciążowa wpływa krytycznie na rozwój i funkcjonowanie łożyska¹⁹²⁰
Nadciśnienie tętnicze – przewlekłe nadciśnienie, nadciśnienie ciążowe i stan przedrzucawkowy zwiększają ryzyko śmierci płodu²¹
Infekcje – niewyleczone infekcje, takie jak kiła, mogą prowadzić do śmierci płodu²²
COVID-19 – badania wykazały zwiększone ryzyko śmierci płodu u kobiet, które przebyły zakażenie COVID-19 podczas ciąży²³²⁴

Inne czynniki ryzyka

Zaawansowany wiek matki²⁵
Ciąża po terminie – ryzyko śmierci płodu wzrasta wraz z przekraczaniem terminu porodu, ponieważ funkcja łożyska ulega stopniowemu pogorszeniu²⁶
Ograniczenie wzrastania płodu – jest silnym markerem potencjalnych problemów z dzieckiem, w tym śmierci płodu²⁷
Nierówności rasowe i etniczne – w Stanach Zjednoczonych kobiety czarnoskóre, rdzenne Amerykanki i mieszkanki Alaski doświadczają nieproporcjonalnie wyższych wskaźników śmierci płodu²⁸

Strategie profilaktyki śmierci płodu

Badania wskazują na kilka kluczowych strategii, które mogą znacząco zmniejszyć ryzyko śmierci płodu. Interwencje te powinny być wdrażane zarówno na poziomie indywidualnym, jak i systemowym²⁹³⁰.

Monitorowanie ruchów płodu

Jedną z najbardziej skutecznych metod profilaktyki jest regularne monitorowanie ruchów płodu, zwłaszcza w trzecim trymestrze ciąży³¹:

Program Count the Kicks – oparty na dowodach program profilaktyki śmierci płodu, który zachęca kobiety w ciąży do codziennego monitorowania ruchów dziecka od 28 tygodnia ciąży³²
Znaczenie zmiany wzorca ruchów – badania pokazują, że zmiana wzorca ruchów płodu w trzecim trymestrze jest wczesnym sygnałem ostrzegawczym³³³⁴
Skuteczność programu – badania wykazały, że program Count the Kicks pomógł obniżyć wskaźnik śmierci płodu w stanie Iowa o ponad 30% w ciągu pierwszych 10 lat funkcjonowania, w czasie gdy ogólnokrajowy wskaźnik w USA pozostał stagnacyjny³⁵

Profilaktyczne stosowanie kwasu acetylosalicylowego

Kwas acetylosalicylowy w małych dawkach może być skuteczny w zapobieganiu stanu przedrzucawkowego, który jest czynnikiem ryzyka śmierci płodu³⁶:

Dawkowanie i czas rozpoczęcia – zaleca się stosowanie kwasu acetylosalicylowego w dawce 50-150 mg/dobę, rozpoczynając przed 16 tygodniem ciąży³⁷³⁸
Skuteczność – badania wykazały, że kwas acetylosalicylowy może być znacznie bardziej skuteczny niż wcześniej sądzono, zwłaszcza przy wysokim poziomie przestrzegania zaleceń przed 16 tygodniem ciąży³⁹
Populacja docelowa – kwas acetylosalicylowy zaleca się osobom o wysokim ryzyku wystąpienia stanu przedrzucawkowego, chociaż międzynarodowe wytyczne różnią się w opisie populacji docelowych dla profilaktycznego stosowania tego leku⁴⁰

Pozycja podczas snu

Zaleca się, aby kobiety w ciąży, szczególnie po 28 tygodniu, spały na boku, a nie na plecach⁴¹:

Mechanizm działania – pozycja na plecach może ograniczać przepływ krwi i tlenu do dziecka⁴²
Badania naukowe – związek między pozycją podczas snu a śmiercią płodu został podkreślony w wielu badaniach, chociaż większość danych pochodzi z badań kliniczno-kontrolnych opartych na kwestionariuszach, które mogą podlegać błędom związanym z retrospektywnym przypominaniem sobie faktów⁴³
Zalecenia – kobieta powinna układać się do snu na boku, co dotyczy zarówno snu nocnego, jak i drzemek w ciągu dnia⁴⁴

Regularne kontrole stanu zdrowia matki i płodu

Regularne wizyty prenatalne umożliwiają monitorowanie stanu zdrowia matki i dziecka oraz wczesne wykrywanie potencjalnych problemów⁴⁵:

Monitorowanie ciśnienia krwi – regularne pomiary ciśnienia krwi pozwalają na wczesne wykrycie objawów stanu przedrzucawkowego⁴⁶
Badania ultrasonograficzne – regularne badania USG pozwalają na monitorowanie wzrostu płodu i wykrywanie ograniczenia wzrastania płodu⁴⁷
Monitorowanie czynności serca płodu – regularne monitorowanie czynności serca płodu może pomóc w identyfikacji potencjalnych problemów⁴⁸
Kardiotokografia – badania sugerują, że kardiotokografia w okresie ciąży może zmniejszyć ryzyko śmierci płodu⁴⁹

Zdrowy styl życia

Prowadzenie zdrowego stylu życia podczas ciąży może pomóc zmniejszyć ryzyko śmierci płodu i zapewnić najlepsze możliwe środowisko dla rozwijającego się dziecka⁵⁰:

Zdrowa dieta – badania wskazują, że zrównoważona suplementacja energetyczno-białkowa może zmniejszyć ryzyko śmierci płodu (RR 0,60, 95% CI 0,39-0,94)⁵¹
Aktywność fizyczna – regularna, umiarkowana aktywność fizyczna jest zalecana dla większości kobiet w ciąży⁵²
Unikanie alkoholu i narkotyków – całkowite unikanie alkoholu i narkotyków podczas ciąży jest jednym z najlepszych sposobów na ochronę zdrowia matki i dziecka⁵³
Rzucenie palenia – zaprzestanie palenia w dowolnym momencie ciąży pomoże, choć im wcześniej, tym lepiej⁵⁴

Szczepienia ochronne

Szczepienia zalecane podczas ciąży mogą pomóc chronić matkę i dziecko przed infekcjami, które mogą zwiększać ryzyko śmierci płodu⁵⁵:

Szczepienie przeciwko COVID-19 – badania sugerują, że szczepienie przeciwko COVID-19 było związane z 15% zmniejszeniem ryzyka śmierci płodu⁵⁶⁵⁷
Szczepienie przeciwko grypie – kobiety w ciąży są bardziej narażone na powikłania grypy, takie jak zapalenie oskrzeli i zapalenie płuc, które mogą zaszkodzić dziecku⁵⁸

Odpowiedni termin porodu

Wybór odpowiedniego momentu porodu może być kluczowy dla zapobiegania śmierci płodu, szczególnie w przypadku ciąż wysokiego ryzyka⁵⁹:

Indukowanie porodu – indukcja porodu może być zalecana w przypadku ciąży po terminie lub w przypadku występowania czynników ryzyka⁶⁰
Ciąża po terminie – indukcja porodu po 41 lub 42 tygodniu ciąży może zmniejszyć ryzyko śmierci płodu⁶¹
Równoważenie ryzyka – decyzja o wcześniejszym porodzie w celu zapobiegania śmierci płodu musi uwzględniać zwiększone ryzyko powikłań dla matki i noworodka w porównaniu z potencjalnymi korzyściami⁶²

Programy i inicjatywy profilaktyczne

Na całym świecie rozwijane są programy i inicjatywy mające na celu zmniejszenie liczby przypadków śmierci płodu. Wiele z nich wykazało znaczną skuteczność w redukcji wskaźników śmierci płodu⁶³⁶⁴.

Safer Baby Bundle

Program Safer Baby Bundle został opracowany w Australii jako pakiet pięciu interwencji opartych na dowodach naukowych, mających na celu zmniejszenie liczby zgonów płodów po 28 tygodniu ciąży⁶⁵:

Elementy pakietu:
- Zaprzestanie palenia tytoniu
- Monitorowanie ruchów płodu
- Wykrywanie zahamowania wzrastania płodu
- Pozycja matki podczas snu
- Optymalny termin porodu
Implementacja – szacuje się, że co najmniej połowa porodów w Australii jest objęta opieką położniczą, która przyjęła ten pakiet⁶⁶
Skuteczność – Australia wyznaczyła cel zmniejszenia wskaźnika śmierci płodu o 20% do 2025 roku⁶⁷

Count the Kicks

Program Count the Kicks, opracowany przez organizację non-profit Healthy Birth Day, Inc., zachęca kobiety w ciąży do codziennego monitorowania ruchów płodu w trzecim trymestrze⁶⁸:

Metoda – program uczy, jak rozpoznawać wzorce ruchów dziecka i zachęca do poszukiwania pomocy medycznej w przypadku zauważenia zmian⁶⁹
Aplikacja mobilna – bezpłatna aplikacja pomaga rodzicom śledzić codzienne wzorce ruchów płodu i zauważyć ewentualne zmiany⁷⁰
Skuteczność – od czasu wprowadzenia programu, wskaźnik śmierci płodu w stanie Iowa spadł o 32%, a wskaźnik śmierci płodu w rodzinach czarnoskórych spadł o 39% w ciągu pierwszych 5 lat programu⁷¹

Modele opieki położniczej

Badania wykazały, że niektóre modele opieki położniczej mogą być skuteczne w zmniejszaniu ryzyka śmierci płodu⁷²:

Model prowadzony przez położne – modele opieki prowadzone przez położne, szczególnie dla kobiet o niskim ryzyku, wykazały zmniejszenie ryzyka zgonu płodu/noworodka (RR 0,84, 95% CI 0,71-0,99)⁷³
Szkolenia dla tradycyjnych asystentek porodowych – w krajach o niskich i średnich dochodach, szkolenie tradycyjnych asystentek porodowych wykazało zmniejszenie liczby zgonów płodu (OR 0,69, 95% CI 0,57-0,83)⁷⁴

Inicjatywy polityczne i legislacyjne

W ostatnich latach podjęto znaczące kroki na szczeblu politycznym i legislacyjnym w celu rozwiązania problemu śmierci płodu⁷⁵.

Maternal and Child Health Stillbirth Prevention Act

Ustawa o profilaktyce śmierci płodu w zakresie zdrowia matki i dziecka, podpisana przez prezydenta Bidena 12 lipca 2024 roku, jest kluczowym aktem prawnym w Stanach Zjednoczonych⁷⁶:

Cel ustawy – dodaje śmierć płodu i profilaktykę śmierci płodu do Tytułu V Ustawy o Zabezpieczeniu Społecznym, co było brakującym elementem od wprowadzenia finansowania z Tytułu V w 1935 roku⁷⁷
Zakres działań – ustawa umożliwia wykorzystanie istniejących funduszy federalnych na działania związane z profilaktyką śmierci płodu, w tym:
- Śledzenie i zwiększanie świadomości na temat ruchów płodu
- Poprawę terminowania porodu dla kobiet z czynnikami ryzyka
- Zachęcanie do bezpiecznych pozycji podczas snu dla kobiet w ciąży
- Badanie przesiewowe i nadzór nad ograniczeniem wzrostu płodu
- Promowanie rzucania palenia wśród kobiet w ciąży
- Wspieranie programów społecznościowych oferujących wizyty domowe lub inne rodzaje wsparcia⁷⁸
Poparcie polityczne – ustawa była dwupartyjną i dwuizbową inicjatywą, która przeszła przez Senat jednogłośnie, a przez Izbę Reprezentantów stosunkiem głosów 408-3⁷⁹⁸⁰

SHINE for Autumn Act

Ustawa SHINE for Autumn Act (Stillbirth Health Improvement and Education) jest kolejną ważną inicjatywą legislacyjną, która przechodzi przez Kongres USA⁸¹:

Cel ustawy – proponuje 45 milionów dolarów w ciągu najbliższych pięciu lat na poprawę gromadzenia danych, badania nad śmiercią płodu, podnoszenie świadomości i edukację, a także wspieranie szkoleń w zakresie autopsji płodu⁸²
Elementy wspólne z australijskim planem – ustawa zawiera elementy, które pojawiły się również w australijskim planie, takie jak poprawa danych, zwiększanie świadomości i zapewnienie wsparcia dla autopsji⁸³

Narodowe plany działania

Różne kraje opracowały krajowe plany działania mające na celu zmniejszenie liczby przypadków śmierci płodu⁸⁴:

Australia – Narodowy Plan Działania i Implementacji w zakresie Śmierci Płodu jest pierwszym krajowym planem zajmującym się tym problemem w Australii. Plan ma na celu zmniejszenie wskaźnika śmierci płodu w Australii o 20% lub więcej do grudnia 2025 roku⁸⁵
Globalny Plan Działania – WHO i UNICEF wezwały do odnowienia zobowiązania do zakończenia przypadków śmierci płodu, którym można zapobiec, do 2030 roku. Plan Every Newborn Action Plan zawiera globalny cel, aby wszystkie kraje osiągnęły wskaźnik śmierci płodu wynoszący 12 lub mniej na 1000 wszystkich urodzeń do 2030 roku⁸⁶

Przyszłość profilaktyki śmierci płodu

Pomimo postępów w profilaktyce śmierci płodu, wciąż istnieje potrzeba dalszych badań i innowacji w celu lepszego zrozumienia i zapobiegania temu problemowi⁸⁷.

Nowe podejścia do profilaktyki

Rozwijane są nowe podejścia do identyfikacji kobiet o zwiększonym ryzyku śmierci płodu⁸⁸:

Ocena funkcji łożyska – poprzez ocenę funkcji łożyska może być możliwe przewidzenie, które dzieci mają większe ryzyko śmierci płodu, co może pozwolić na interwencję przed wystąpieniem zgonu⁸⁹
Biomarkery łożyskowe – utworzono krajową współpracę w celu identyfikacji nowych biomarkerów łożyskowych do testów przedklinicznych⁹⁰
Wykrywanie niedotlenienia płodu – wykrywanie dzieci, które mają zwiększone ryzyko wystąpienia stresu podczas porodu, może pomóc w zmniejszeniu zarówno śmierci płodu, jak i niepełnosprawności u dzieci⁹¹

Potrzeby w zakresie badań

Istnieje pilna potrzeba przeprowadzenia dalszych badań nad profilaktyką śmierci płodu⁹²:

Randomizowane badania kliniczne – potrzebne są duże, odpowiednio zaprojektowane randomizowane badania kliniczne, aby przetestować, czy interwencje mogą zminimalizować ryzyko śmierci płodu⁹³
Badania nad efektywnością programów monitorowania ruchów płodu – ogólnie rzecz biorąc, dowody są niewystarczające, aby wykazać profilaktykę śmierci płodu poprzez monitorowanie ruchów płodu w krajach o wysokich dochodach⁹⁴⁹⁵
Badania nad stosowaniem kwasu acetylosalicylowego – niewiele badań dotyczących stosowania kwasu acetylosalicylowego w ciąży ma wystarczającą moc, aby wykryć zmniejszenie ryzyka śmierci płodu⁹⁶

Wnioski i zalecenia

Pomimo postępów w zrozumieniu i profilaktyce śmierci płodu, wciąż istnieje potrzeba skoordynowanych działań na szczeblu indywidualnym, społecznościowym i politycznym w celu dalszego zmniejszania liczby przypadków śmierci płodu⁹⁷⁹⁸.

Kluczowe strategie profilaktyki śmierci płodu obejmują:

Regularne wizyty prenatalne i badania kontrolne
Monitorowanie ruchów płodu, szczególnie w trzecim trymestrze
Zdrowy styl życia podczas ciąży, w tym zdrowa dieta, aktywność fizyczna i unikanie substancji szkodliwych
Spanie na boku, a nie na plecach, po 28 tygodniu ciąży
Profilaktyczne stosowanie kwasu acetylosalicylowego u kobiet o wysokim ryzyku stanu przedrzucawkowego
Szczepienia ochronne, w tym przeciwko COVID-19 i grypie
Odpowiednie zarządzanie chorobami współistniejącymi, takimi jak cukrzyca i nadciśnienie tętnicze
Odpowiedni termin porodu, szczególnie w przypadku ciąż wysokiego ryzyka

Implementacja dowodów naukowych poprzez krajowe plany działania, takie jak Safer Baby Bundle w Australii i programy takie jak Count the Kicks w Stanach Zjednoczonych, może przyczynić się do znacznej redukcji liczby przypadków śmierci płodu⁹⁹.

Należy również zwrócić uwagę na nierówności w zakresie zdrowia, które sprawiają, że niektóre grupy kobiet są bardziej narażone na ryzyko śmierci płodu, i podjąć działania w celu ich wyeliminowania¹⁰⁰.

Podsumowując, chociaż nie wszystkim przypadkom śmierci płodu można zapobiec, istnieją konkretne działania, które można podjąć na poziomie indywidualnym, systemowym i politycznym, aby zmniejszyć ryzyko i zapewnić jak najwięcej zdrowych urodzeń¹⁰¹.

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Materiały źródłowe

#1 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#2 Stillbirth prevention
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/stillbirth-prevention
About one stillbirth occurs every 16 seconds, for a total of an estimated 2 million stillborn babies per year according to the latest WHO and UNICEF estimates. More than 40% of stillbirths occur during labour and birth and are preventable with high quality care during pregnancy and birth. WHO, UNICEF and other partners have called for a renewed commitment to end preventable stillbirths by 2030. The Every Newborn Action Plan includes a global target for stillbirth reduction that all countries achieve a stillbirth rate of 12 or fewer per 1000 total births by 2030, which was adopted in the Global Strategy for Womens, Childrens, and Adolescents Health 2016-2030. This will require working toward the ENAP stillbirth targets, the ENAP coverage targets to close the equity gap within countries, meeting antenatal and intrapartum quality care targets, achieve consensus on bereavement care and materials, and take global action to reduce the stigma around stillbirth. […] To attain this ambitious target, WHO is committed to: Increase the understanding of stillbirth, Reduce stigma, taboo and misconception, Set national and local stillbirth reduction targets, Strengthen health systems to provide high-quality care.
#3 Management of Stillbirth | ACOG
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2020/03/management-of-stillbirth
Stillbirth is one of the most common adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. […] The purpose of this document is to review the current information on stillbirth, including definitions and management, the evaluation of a stillbirth, and strategies for prevention. […] Evaluation of a stillbirth should include fetal autopsy; gross and histologic examination of the placenta, umbilical cord, and membranes; and genetic evaluation. […] Health care providers should weigh the risks and benefits of each strategy in a given clinical scenario and consider available institutional expertise. Patient support should include emotional support and clear communication of test results. Referral to a bereavement counselor, peer support group, or mental health professional may be advisable for management of grief and depression.
#4 Stillbirth prevention
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/stillbirth-prevention
About one stillbirth occurs every 16 seconds, for a total of an estimated 2 million stillborn babies per year according to the latest WHO and UNICEF estimates. More than 40% of stillbirths occur during labour and birth and are preventable with high quality care during pregnancy and birth. WHO, UNICEF and other partners have called for a renewed commitment to end preventable stillbirths by 2030. The Every Newborn Action Plan includes a global target for stillbirth reduction that all countries achieve a stillbirth rate of 12 or fewer per 1000 total births by 2030, which was adopted in the Global Strategy for Womens, Childrens, and Adolescents Health 2016-2030. This will require working toward the ENAP stillbirth targets, the ENAP coverage targets to close the equity gap within countries, meeting antenatal and intrapartum quality care targets, achieve consensus on bereavement care and materials, and take global action to reduce the stigma around stillbirth. […] To attain this ambitious target, WHO is committed to: Increase the understanding of stillbirth, Reduce stigma, taboo and misconception, Set national and local stillbirth reduction targets, Strengthen health systems to provide high-quality care.
#5
https://www.who.int/health-topics/stillbirth
A baby who dies after 28 weeks of pregnancy, but before or during birth, is classified as a stillbirth. […] Over 40% of all stillbirths occur during labour a loss that could be avoided with improved quality and respectful care during childbirth including routine monitoring and timely access to emergency obstetric care when required. […] With quality health care throughout pregnancy and childbirth, most stillbirths are preventable. […] Stillbirths can be prevented through family planning to avoid unwanted pregnancies, good health and nutrition prior to and during pregnancy, quality and respectful antenatal and childbirth care including adequate skilled health personnel including midwives. […] Syphilis treatment in pregnancy could also prevent an estimated 200 000 stillbirths, while fetal heart rate monitoring and labour surveillance and prompt interventions when needed are crucial for preventing 832 000 intrapartum stillbirths and reducing neonatal deaths.
#6 Merkleyâs Bipartisan Maternal and Child Health Stillbirth Prevention Act Signed into LawÂ – Merkley
https://www.merkley.senate.gov/merkleys-bipartisan-maternal-and-child-health-stillbirth-prevention-act-signed-into-law/
Recent reports and data suggest the United States can and must do more to prevent stillbirth, highlighting that at least 25 percent of stillbirths are potentially preventable. According to the Centers for Disease Control and Prevention, one out of 175 U.S. births tragically result in stillbirthsaccounting for nearly 21,000 stillbirths a yearmore stillbirths annually than the number of babies who pass away during their first year of life. In the last two decades, the stillbirth rate in the United States declined by a negligible 0.4 percent, and, in a report published by the World Health Organization comparing progress in improving stillbirth rates, the United States ranked 183 out of 195 countries. […] The Maternal and Child Health Stillbirth Prevention Act passed the Senate unanimously and passed the House with a bipartisan vote of 408-3. […] The House version was led by U.S. Representatives Ashley Hinson (R-IA-02) and Alma Adams (D-NC-12).
#7
https://www.dsmpartnership.com/news-media/blog/iowa-led-stillbirth-prevention-bill-passes-us-house-shortly-after-dmdc-trip
Recent reports and data suggest that further reduction in the incidence of stillbirth is possible, highlighting that nearly 25% of stillbirths are potentially preventable. […] The Count the Kicks program has shown promise in addressing racial disparities in birth outcomes. In the first 5 years of the program, the stillbirth rate for Black families in Iowa went down 39%. […] The Maternal and Child Health Stillbirth Prevention Act provides both clarity and a vital call to action from Congress to state health departments across the nation that they can and should use a portion of the existing $2.6 billion of Title V Block Grant funding to prevent stillbirth. […] Currently fewer than 20 state health departments are using a portion of these existing funds to address stillbirth, leaving expectant parents in most U.S. states and territories more vulnerable to stillbirth. This clarification will support stillbirth prevention activities, thereby helping to save the lives of mothers and babies. […] Our organization estimates more than 6,000 babies will be saved each year from preventable stillbirth once all 50 states adopt proven stillbirth prevention efforts.
#8 Stillbirth Prevention: Things You Can Do to Reduce the Risk of Stillbirth
https://blog.mommylabornurse.com/stillbirth-prevention
By definition, stillbirth is the death of a baby any time after the 20th week of pregnancy or during delivery. […] An estimated 25% of stillbirths are classified as potentially preventable. […] My friends over at PUSH for Empowered Pregnancy are doing incredible work for this effort. They provide the most comprehensive information and actionable tips I’ve seen to really do something about these outrageous facts. […] The first of that advice is to remember that there is no pregnancy safe zone when it comes to loss. […] Simply knowing this as a fact, and having information about how to spot a problem is so powerful to helping your provider intervene accordingly. […] We cannot decrease the rate of stillbirths without empowering mamas and their partners with the signs of fetal distress and teaching them how to advocate for themselves and their babies.
#9 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#10 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#11 Reducing the risk of stillbirth | The Royal Women’s Hospital
https://www.thewomens.org.au/health-information/pregnancy-and-birth/a-healthy-pregnancy/reducing-the-risk-of-stillbirth
Smoking in pregnancy is one of the main causes of stillbirth. […] By smoking during pregnancy, you increase the risk of miscarriage or stillbirth, premature birth, Sudden Unexplained Death in Infancy (SUDI including SIDS), low birth weight and breathing problems. […] If you are concerned about any change in your babys movements contact your midwife or doctor immediately. […] Research shows that from 28 weeks of pregnancy there is a link between the position that a mother goes to sleep in and stillbirth. […] If you are pregnant, it is recommended that you settle into sleep on your side. […] If your pregnancy is continuing with no issues then birth close to 40 weeks is best, however, if there are health concerns for you or your baby, your care team will discuss these with you. […] The Women’s is one of several maternity services working together as part of the Safer Baby Collaborative to reduce the rates of stillbirth.
#12 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#13 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. […] Obesity (having a BMI over 30) increases the risk of stillbirth. Itâs a good idea to get to a healthy weight before getting pregnant. If youâre pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy. […] Itâs important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby’s development and increase the risk of miscarriage and stillbirth. […] Go to all your antenatal appointments and scans so midwives can check your babyâs growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth. […] Without more research, we will never know why so many babies die before birth. Tommyâs Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.
#14 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
The safest way to ensure your baby is not damaged by alcohol is not to drink while you’re pregnant. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth. […] It’s thought this may be to do with the flow of blood and oxygen to the baby. […] Using illegal drugs during pregnancy could harm your baby. […] Pregnant women are more at risk from flu complications, such as bronchitis and pneumonia, than the general population. […] These complications can harm your baby. […] It’s important to prepare and store food safely to reduce the risk of infection. […] You should avoid some foods in pregnancy, as they have a higher risk of making you ill with infections such as listeria and salmonella. […] Call your midwife or maternity unit straight away if your baby’s movements have reduced, changed or stopped. […] Vaginal bleeding may indicate a problem. […] If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.
#15 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
The safest way to ensure your baby is not damaged by alcohol is not to drink while you’re pregnant. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth. […] It’s thought this may be to do with the flow of blood and oxygen to the baby. […] Using illegal drugs during pregnancy could harm your baby. […] Pregnant women are more at risk from flu complications, such as bronchitis and pneumonia, than the general population. […] These complications can harm your baby. […] It’s important to prepare and store food safely to reduce the risk of infection. […] You should avoid some foods in pregnancy, as they have a higher risk of making you ill with infections such as listeria and salmonella. […] Call your midwife or maternity unit straight away if your baby’s movements have reduced, changed or stopped. […] Vaginal bleeding may indicate a problem. […] If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.
#16
https://www.nhs.uk/conditions/stillbirth/prevention/
Obesity increases the risk of stillbirth. The best way to protect your health and your baby’s wellbeing is to lose weight before becoming pregnant. By reaching a healthy weight, you cut your risk of all the problems associated with obesity in pregnancy. […] If you notice your baby is moving less than usual, or there’s a change in the pattern of movements, it may be the first sign your baby is unwell. You should contact your midwife or local maternity unit immediately so your baby’s wellbeing can be assessed. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy can increase the risk of stillbirth. It’s thought this may be to do with the flow of blood and oxygen to the baby.
#17 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#18 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#19 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
A 2013 systematic review of randomised controlled trials showed reduced pre-eclampsia, perinatal death, and fetal growth restriction among individuals at high risk commenced on aspirin before 16 weeks. […] Few studies examining aspirin use in pregnancy are powered to detect stillbirth risk reduction. […] Risk stratification is undergoing debate, and international guidelines inconsistently describe target populations for prophylactic aspirin. […] Gestational diabetes mellitus is glucose intolerance diagnosed during pregnancy. This disorder is associated with adverse pregnancy outcomes; fetal macrosomia, shoulder dystocia, neonatal hypoglycaemia, congenital abnormalities, maternal hypertensive disease, future type two diabetes mellitus, and antepartum stillbirth. […] The pathogenesis of stillbirth associated with gestational diabetes mellitus is unclear, however, glucose dysmetabolism critically impacts placental development and function.
#20 Stillbirth: A Health Professionalâs Role | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-health-professionals-role
Gestational diabetes is associated with stillbirth, plausibly through impacts on placental development and function. […] Chronic hypertension, superimposed preeclampsia, and preeclampsia are all associated with increased risk for stillbirth, preterm delivery, low birth weight, neonatal intensive care unit (NICU) admission, and cesarean delivery. […] Evidence indicates that prophylactic aspirin, 50-150 mg/day initiated at 16 weeks gestational age can prevent pre-eclampsia, fetal growth restriction and perinatal mortality for patients with hypertensive disorders or pre-eclampsia risk factors with few apparent downsides.
#21 Stillbirth: A Health Professionalâs Role | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-health-professionals-role
Gestational diabetes is associated with stillbirth, plausibly through impacts on placental development and function. […] Chronic hypertension, superimposed preeclampsia, and preeclampsia are all associated with increased risk for stillbirth, preterm delivery, low birth weight, neonatal intensive care unit (NICU) admission, and cesarean delivery. […] Evidence indicates that prophylactic aspirin, 50-150 mg/day initiated at 16 weeks gestational age can prevent pre-eclampsia, fetal growth restriction and perinatal mortality for patients with hypertensive disorders or pre-eclampsia risk factors with few apparent downsides.
#22
https://www.who.int/health-topics/stillbirth
A baby who dies after 28 weeks of pregnancy, but before or during birth, is classified as a stillbirth. […] Over 40% of all stillbirths occur during labour a loss that could be avoided with improved quality and respectful care during childbirth including routine monitoring and timely access to emergency obstetric care when required. […] With quality health care throughout pregnancy and childbirth, most stillbirths are preventable. […] Stillbirths can be prevented through family planning to avoid unwanted pregnancies, good health and nutrition prior to and during pregnancy, quality and respectful antenatal and childbirth care including adequate skilled health personnel including midwives. […] Syphilis treatment in pregnancy could also prevent an estimated 200 000 stillbirths, while fetal heart rate monitoring and labour surveillance and prompt interventions when needed are crucial for preventing 832 000 intrapartum stillbirths and reducing neonatal deaths.
#23 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#24 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias. […] In a case-control study comparing 153 individuals who had experienced stillbirth with 480 people with an ongoing pregnancy or live delivery, those who had a stillbirth were much more likely to have had reduced fetal movements in the preceding two weeks. […] Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Vaccination may reduce stillbirth risk; a meta-analysis of 23 observational studies showed marginally lower stillbirth risk among individuals vaccinated against covid-19. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now. Two examples that we highlight are improving identification and management diabetes in pregnancy and prophylactic aspirin administration.
#25 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#26 Five ways to reduce the risk of stillbirth – The University of Sydney
https://www.sydney.edu.au/news-opinion/news/2018/12/11/five-ways-to-reduce-the-risk-of-stillbirth.html
Smoking during pregnancy is strongly associated with stillbirth and other serious problems such as fetal growth restriction, premature birth, and SIDS. […] Fetal growth restriction when the baby isn’t growing well is a strong marker of potential problems with the baby, including stillbirth, death in the first weeks of life and also chronic diseases later in life. […] The risk of stillbirth increases as women approach and go past their due date, as the placental function decreases. […] However, the benefit of reducing the risk of stillbirth via an early birth needs to be carefully weighed against the risk of intervention for the baby at a given gestation. […] While the Senate report highlighted need for further research to better understand and predict who is at highest risk of stillbirth, with what is already known, we can substantially reduce the numbers of stillborn babies and families who suffer the tragedy of this loss.
#27 Five ways to reduce the risk of stillbirth – The University of Sydney
https://www.sydney.edu.au/news-opinion/news/2018/12/11/five-ways-to-reduce-the-risk-of-stillbirth.html
Smoking during pregnancy is strongly associated with stillbirth and other serious problems such as fetal growth restriction, premature birth, and SIDS. […] Fetal growth restriction when the baby isn’t growing well is a strong marker of potential problems with the baby, including stillbirth, death in the first weeks of life and also chronic diseases later in life. […] The risk of stillbirth increases as women approach and go past their due date, as the placental function decreases. […] However, the benefit of reducing the risk of stillbirth via an early birth needs to be carefully weighed against the risk of intervention for the baby at a given gestation. […] While the Senate report highlighted need for further research to better understand and predict who is at highest risk of stillbirth, with what is already known, we can substantially reduce the numbers of stillborn babies and families who suffer the tragedy of this loss.
#28 Adams, Hinson, Merkley, Cassidyâs Stillbirth Prevention Act Overwhelmingly Passes U.S. House | Congresswoman Alma Adams
https://adams.house.gov/media-center/press-releases/adams-hinson-merkley-cassidys-stillbirth-prevention-act-overwhelmingly
Nearly 1 in 4 stillbirths are potentially preventable, and I applaud the House for passing this bill to ensure robust federal resources go towards stillbirth prevention activities and research. […] We can save the lives of babies and mothers by improving access to stillbirth prevention. […] Stillbirth remains one of our most underfunded and understudied public health issues and the Maternal and Child Health Stillbirth Prevention Act is a critical step in stillbirth prevention and protecting the health of pregnant women and infants. […] Families have grieved in silence for decades – and this legislation says we can end preventable stillbirths. […] The passage of the Maternal and Child Health Stillbirth Prevention Act is a significant milestone, as it signals a turning point where stillbirth is no longer overlooked. […] March of Dimes is pleased to see the House pass the Maternal and Child Health Stillbirth Prevention Act (S.2231/H.R.4581), which will allow states to use resources under the Title V Maternal and Infant Health Block Grant for stillbirth prevention programs.
#29 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Around half of the twomillion stillbirths occurring worldwide each year are preventable. This review compiles the most up-to-date evidence to inform stillbirth prevention. Many general maternal health interventions also reduce the risk of stillbirth, for example, antenatal care attendance. This review focuses on specific aspects of care: glucose metabolism, targeted aspirin prophylaxis, clotting and immune disorders, sleep positions, fetal movement monitoring, and preconception and interconception health. […] Action must be taken with the evidence available now, in healthcare settings with high or low resources, to reduce stillbirths and improve training and care. […] Prevention efforts are essential but, equally as important, all parents who experience a stillborn baby must receive high quality, supportive bereavement care.
#30 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#31 Maine CDC and Partners Expand Stillbirth Prevention Program | Department of Health and Human Services
https://www.maine.gov/dhhs/blog/maine-cdc-and-partners-expand-stillbirth-prevention-program-2024-03-20
The Maine Center for Disease Control and Prevention (Maine CDC) is partnering with Count the Kicks, an evidence-based stillbirth prevention program, to educate expectant parents about the importance of paying attention to their babys movements in the third trimester of pregnancy. […] Research shows that nearly 30% of stillbirths can be prevented when expectant parents are educated on how to monitor their babys movements once a day starting at 28 weeks. […] Evidence shows that a change in a babys movements in the third trimester is an early red flag. […] Research shows that the Count the Kicks campaign helped lower the stillbirth rate in Iowa by more than 30% in the first 10 years of the prevention program at a time when Americas overall stillbirth rate remained stagnant.
#32 Maine CDC and Partners Expand Stillbirth Prevention Program | Department of Health and Human Services
https://www.maine.gov/dhhs/blog/maine-cdc-and-partners-expand-stillbirth-prevention-program-2024-03-20
The Maine Center for Disease Control and Prevention (Maine CDC) is partnering with Count the Kicks, an evidence-based stillbirth prevention program, to educate expectant parents about the importance of paying attention to their babys movements in the third trimester of pregnancy. […] Research shows that nearly 30% of stillbirths can be prevented when expectant parents are educated on how to monitor their babys movements once a day starting at 28 weeks. […] Evidence shows that a change in a babys movements in the third trimester is an early red flag. […] Research shows that the Count the Kicks campaign helped lower the stillbirth rate in Iowa by more than 30% in the first 10 years of the prevention program at a time when Americas overall stillbirth rate remained stagnant.
#33 Maine CDC and Partners Expand Stillbirth Prevention Program | Department of Health and Human Services
https://www.maine.gov/dhhs/blog/maine-cdc-and-partners-expand-stillbirth-prevention-program-2024-03-20
The Maine Center for Disease Control and Prevention (Maine CDC) is partnering with Count the Kicks, an evidence-based stillbirth prevention program, to educate expectant parents about the importance of paying attention to their babys movements in the third trimester of pregnancy. […] Research shows that nearly 30% of stillbirths can be prevented when expectant parents are educated on how to monitor their babys movements once a day starting at 28 weeks. […] Evidence shows that a change in a babys movements in the third trimester is an early red flag. […] Research shows that the Count the Kicks campaign helped lower the stillbirth rate in Iowa by more than 30% in the first 10 years of the prevention program at a time when Americas overall stillbirth rate remained stagnant.
#34 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias. […] In a case-control study comparing 153 individuals who had experienced stillbirth with 480 people with an ongoing pregnancy or live delivery, those who had a stillbirth were much more likely to have had reduced fetal movements in the preceding two weeks. […] Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Vaccination may reduce stillbirth risk; a meta-analysis of 23 observational studies showed marginally lower stillbirth risk among individuals vaccinated against covid-19. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now. Two examples that we highlight are improving identification and management diabetes in pregnancy and prophylactic aspirin administration.
#35 Maine CDC and Partners Expand Stillbirth Prevention Program | Department of Health and Human Services
https://www.maine.gov/dhhs/blog/maine-cdc-and-partners-expand-stillbirth-prevention-program-2024-03-20
The Maine Center for Disease Control and Prevention (Maine CDC) is partnering with Count the Kicks, an evidence-based stillbirth prevention program, to educate expectant parents about the importance of paying attention to their babys movements in the third trimester of pregnancy. […] Research shows that nearly 30% of stillbirths can be prevented when expectant parents are educated on how to monitor their babys movements once a day starting at 28 weeks. […] Evidence shows that a change in a babys movements in the third trimester is an early red flag. […] Research shows that the Count the Kicks campaign helped lower the stillbirth rate in Iowa by more than 30% in the first 10 years of the prevention program at a time when Americas overall stillbirth rate remained stagnant.
#36 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Some aspects of stillbirth prevention (eg, the use of aspirin to prevent pre-eclampsia) have been well researched, however, these remain the exception. […] A large cross sectional study of 90000 women reported more pregnancy complications (eg, shoulder dystocia and neonatal intensive care unit admission) among those not meeting current gestational diabetes mellitus diagnostic criteria, but who met the more sensitive International Association of Diabetes and Pregnancy Study Groups criteria (versus women who met neither diagnostic criteria). […] Recent evidence suggests that aspirin might be much more effective than previously thought, with high compliance preceding 16 weeks; note, the effectiveness of aspirin on pre-eclampsia greatly reduced with decreasing compliance. […] The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias.
#37 Stillbirth: A Health Professionalâs Role | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-health-professionals-role
Gestational diabetes is associated with stillbirth, plausibly through impacts on placental development and function. […] Chronic hypertension, superimposed preeclampsia, and preeclampsia are all associated with increased risk for stillbirth, preterm delivery, low birth weight, neonatal intensive care unit (NICU) admission, and cesarean delivery. […] Evidence indicates that prophylactic aspirin, 50-150 mg/day initiated at 16 weeks gestational age can prevent pre-eclampsia, fetal growth restriction and perinatal mortality for patients with hypertensive disorders or pre-eclampsia risk factors with few apparent downsides.
#38 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
A 2013 systematic review of randomised controlled trials showed reduced pre-eclampsia, perinatal death, and fetal growth restriction among individuals at high risk commenced on aspirin before 16 weeks. […] Few studies examining aspirin use in pregnancy are powered to detect stillbirth risk reduction. […] Risk stratification is undergoing debate, and international guidelines inconsistently describe target populations for prophylactic aspirin. […] Gestational diabetes mellitus is glucose intolerance diagnosed during pregnancy. This disorder is associated with adverse pregnancy outcomes; fetal macrosomia, shoulder dystocia, neonatal hypoglycaemia, congenital abnormalities, maternal hypertensive disease, future type two diabetes mellitus, and antepartum stillbirth. […] The pathogenesis of stillbirth associated with gestational diabetes mellitus is unclear, however, glucose dysmetabolism critically impacts placental development and function.
#39 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Some aspects of stillbirth prevention (eg, the use of aspirin to prevent pre-eclampsia) have been well researched, however, these remain the exception. […] A large cross sectional study of 90000 women reported more pregnancy complications (eg, shoulder dystocia and neonatal intensive care unit admission) among those not meeting current gestational diabetes mellitus diagnostic criteria, but who met the more sensitive International Association of Diabetes and Pregnancy Study Groups criteria (versus women who met neither diagnostic criteria). […] Recent evidence suggests that aspirin might be much more effective than previously thought, with high compliance preceding 16 weeks; note, the effectiveness of aspirin on pre-eclampsia greatly reduced with decreasing compliance. […] The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias.
#40 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
A 2013 systematic review of randomised controlled trials showed reduced pre-eclampsia, perinatal death, and fetal growth restriction among individuals at high risk commenced on aspirin before 16 weeks. […] Few studies examining aspirin use in pregnancy are powered to detect stillbirth risk reduction. […] Risk stratification is undergoing debate, and international guidelines inconsistently describe target populations for prophylactic aspirin. […] Gestational diabetes mellitus is glucose intolerance diagnosed during pregnancy. This disorder is associated with adverse pregnancy outcomes; fetal macrosomia, shoulder dystocia, neonatal hypoglycaemia, congenital abnormalities, maternal hypertensive disease, future type two diabetes mellitus, and antepartum stillbirth. […] The pathogenesis of stillbirth associated with gestational diabetes mellitus is unclear, however, glucose dysmetabolism critically impacts placental development and function.
#41 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. […] Obesity (having a BMI over 30) increases the risk of stillbirth. Itâs a good idea to get to a healthy weight before getting pregnant. If youâre pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy. […] Itâs important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby’s development and increase the risk of miscarriage and stillbirth. […] Go to all your antenatal appointments and scans so midwives can check your babyâs growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth. […] Without more research, we will never know why so many babies die before birth. Tommyâs Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.
#42 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
The safest way to ensure your baby is not damaged by alcohol is not to drink while you’re pregnant. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth. […] It’s thought this may be to do with the flow of blood and oxygen to the baby. […] Using illegal drugs during pregnancy could harm your baby. […] Pregnant women are more at risk from flu complications, such as bronchitis and pneumonia, than the general population. […] These complications can harm your baby. […] It’s important to prepare and store food safely to reduce the risk of infection. […] You should avoid some foods in pregnancy, as they have a higher risk of making you ill with infections such as listeria and salmonella. […] Call your midwife or maternity unit straight away if your baby’s movements have reduced, changed or stopped. […] Vaginal bleeding may indicate a problem. […] If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.
#43 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Some aspects of stillbirth prevention (eg, the use of aspirin to prevent pre-eclampsia) have been well researched, however, these remain the exception. […] A large cross sectional study of 90000 women reported more pregnancy complications (eg, shoulder dystocia and neonatal intensive care unit admission) among those not meeting current gestational diabetes mellitus diagnostic criteria, but who met the more sensitive International Association of Diabetes and Pregnancy Study Groups criteria (versus women who met neither diagnostic criteria). […] Recent evidence suggests that aspirin might be much more effective than previously thought, with high compliance preceding 16 weeks; note, the effectiveness of aspirin on pre-eclampsia greatly reduced with decreasing compliance. […] The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias.
#44 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. […] Obesity (having a BMI over 30) increases the risk of stillbirth. Itâs a good idea to get to a healthy weight before getting pregnant. If youâre pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy. […] Itâs important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby’s development and increase the risk of miscarriage and stillbirth. […] Go to all your antenatal appointments and scans so midwives can check your babyâs growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth. […] Without more research, we will never know why so many babies die before birth. Tommyâs Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.
#45 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#46 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. […] Obesity (having a BMI over 30) increases the risk of stillbirth. Itâs a good idea to get to a healthy weight before getting pregnant. If youâre pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy. […] Itâs important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby’s development and increase the risk of miscarriage and stillbirth. […] Go to all your antenatal appointments and scans so midwives can check your babyâs growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth. […] Without more research, we will never know why so many babies die before birth. Tommyâs Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.
#47 Stillbirth: How Common, Causes, Symptoms & Support
https://my.clevelandclinic.org/health/diseases/9685-stillbirth
A stillbirth can happen during any pregnancy. But health, lifestyle and environment all shape the risks associated with pregnancy loss. […] Improved prenatal care has led to reduced rates of stillbirths worldwide. But there’s a long way to go to reduce healthcare disparities (differences) that make some people more likely to experience stillbirths than others. […] Access to high-quality prenatal care can often reduce the risk of stillbirths related to infections. […] Theres usually nothing you can do to prevent a stillbirth. Often, it happens because of a medical condition or complication outside of your control. But you can take steps to increase the odds of delivering a healthy baby: […] Get routine tests, ultrasounds and/or fetal heart monitoring as needed. Regular checkups can help your healthcare provider identify any conditions that may affect your pregnancy. This is especially important if you’re at high risk for pregnancy complications.
#48 Stillbirth: How Common, Causes, Symptoms & Support
https://my.clevelandclinic.org/health/diseases/9685-stillbirth
A stillbirth can happen during any pregnancy. But health, lifestyle and environment all shape the risks associated with pregnancy loss. […] Improved prenatal care has led to reduced rates of stillbirths worldwide. But there’s a long way to go to reduce healthcare disparities (differences) that make some people more likely to experience stillbirths than others. […] Access to high-quality prenatal care can often reduce the risk of stillbirths related to infections. […] Theres usually nothing you can do to prevent a stillbirth. Often, it happens because of a medical condition or complication outside of your control. But you can take steps to increase the odds of delivering a healthy baby: […] Get routine tests, ultrasounds and/or fetal heart monitoring as needed. Regular checkups can help your healthcare provider identify any conditions that may affect your pregnancy. This is especially important if you’re at high risk for pregnancy complications.
#49 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#50 Reducing the risk of stillbirth | Raising Children Network
https://raisingchildren.net.au/pregnancy/miscarriage-stillbirth/stillbirth-and-neonatal-death/stillbirth-reducing-the-risks
Most women have healthy pregnancies. But stillbirths sometimes happen. […] You cant always prevent stillbirth. But there are things you can do to reduce the risk of stillbirth. These include: being aware of baby movements, going to sleep on your side, having a healthy lifestyle, going to your antenatal appointments. […] Going to sleep on your side during pregnancy reduces the risk of stillbirth, especially in the third trimester that is, from 28 weeks of pregnancy until birth. […] A healthy lifestyle during pregnancy can help to reduce the risk of stillbirth and provide the best possible environment for your growing baby. […] When you go to your antenatal appointments, your midwife or doctor can check how you and your baby are going. […] Some factors can put pregnant women at higher risk for stillbirth. […] Its a good idea to ask your midwife or doctor about your individual risks for stillbirth. If you have a risk factor for stillbirth, your midwife or doctor can talk with you about what you can do to reduce your risk.
#51 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Stillbirth is generally defined as a death prior to birth at or after 22 weeks’ gestation. It remains a major public health concern globally. Antenatal interventions may reduce stillbirths and improve maternal and neonatal outcomes in settings with high rates of stillbirth. There are several key antenatal strategies that aim to prevent stillbirth including nutrition, and prevention and management of infections. […] We identified 43 Cochrane Reviews that included interventions in pregnant women with the potential for preventing stillbirth; all of the included reviews reported our primary outcome 'stillbirth’ or in the absence of stillbirth, 'perinatal death’ or 'fetal loss/fetal death’. […] Clear evidence of benefit: balanced energy/protein supplementation versus no supplementation suggests a probable reduction in stillbirth (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.94, 5 randomised controlled trials (RCTs), 3408 women; moderate certainty evidence).
#52 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#53 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. […] Obesity (having a BMI over 30) increases the risk of stillbirth. Itâs a good idea to get to a healthy weight before getting pregnant. If youâre pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy. […] Itâs important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby’s development and increase the risk of miscarriage and stillbirth. […] Go to all your antenatal appointments and scans so midwives can check your babyâs growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth. […] Without more research, we will never know why so many babies die before birth. Tommyâs Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.
#54 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses. […] Try to swap unhealthy foods for healthier options, and try to keep active. […] Being overweight or obese can increase the risk of problems in pregnancy. […] If you smoke, the best thing you can do is to stop. […] Stopping at any time in pregnancy will help, though the sooner the better.
#55 Stillbirth Awareness | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-awareness
Get Recommended Vaccines: Vaccinations recommended during pregnancy can help protect you against infections that can harm you and your developing baby. If a pregnant person catches COVID-19, there is a higher risk of stillbirth. However, getting vaccinated against COVID-19 can help protect you. Research suggests that COVID-19 vaccination was associated with a 15% decrease in stillbirth risk. […] Manage Diabetes: Gestational diabetes, which is diabetes that occurs during pregnancy, is linked to a higher risk of stillbirth. Diabetes can affect how the placenta grows and works, which can increase the chances of stillbirth. […] Manage High Blood Pressure: High blood pressure during pregnancy can put you and your baby at risk for problems like stillbirth, low birth weight, and cesarean delivery (c-section). The good news is that high blood pressure is preventable and treatable.
#56 Stillbirth Awareness | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-awareness
Get Recommended Vaccines: Vaccinations recommended during pregnancy can help protect you against infections that can harm you and your developing baby. If a pregnant person catches COVID-19, there is a higher risk of stillbirth. However, getting vaccinated against COVID-19 can help protect you. Research suggests that COVID-19 vaccination was associated with a 15% decrease in stillbirth risk. […] Manage Diabetes: Gestational diabetes, which is diabetes that occurs during pregnancy, is linked to a higher risk of stillbirth. Diabetes can affect how the placenta grows and works, which can increase the chances of stillbirth. […] Manage High Blood Pressure: High blood pressure during pregnancy can put you and your baby at risk for problems like stillbirth, low birth weight, and cesarean delivery (c-section). The good news is that high blood pressure is preventable and treatable.
#57 Stillbirth: A Health Professionalâs Role | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/womens-health/pregnancy/stillbirth-health-professionals-role
The loss of a baby due to stillbirth is a devastating reality for many families and takes a serious toll on their health and well-being. Healthcare providers play an important role in preventing stillbirths through proactive care and education. Here is how you can help. […] Preventing poor perinatal outcomes, like stillbirth, begins by listening to your patients concerns, believing their experience, and recognizing that racism and subconscious bias is directly associated with adverse outcomes. […] Evidence indicates that adequate prenatal care protects against stillbirth, neonatal death and infant death. […] Reducing/eliminating alcohol and drug use is one of the best ways to protect the pregnant person and their baby. […] Research suggests theres a higher risk of stillbirth among pregnant persons with COVID. This protection is especially strong against the Delta variant, which was prominent in 2021, but it still helps with other variants. The COVID-19 vaccination was associated with a 15% (OR 0.85, 0.73-0.99) decrease in stillbirth risk.
#58 What you can do to reduce the risk of stillbirth – NHS
https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/
The safest way to ensure your baby is not damaged by alcohol is not to drink while you’re pregnant. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth. […] It’s thought this may be to do with the flow of blood and oxygen to the baby. […] Using illegal drugs during pregnancy could harm your baby. […] Pregnant women are more at risk from flu complications, such as bronchitis and pneumonia, than the general population. […] These complications can harm your baby. […] It’s important to prepare and store food safely to reduce the risk of infection. […] You should avoid some foods in pregnancy, as they have a higher risk of making you ill with infections such as listeria and salmonella. […] Call your midwife or maternity unit straight away if your baby’s movements have reduced, changed or stopped. […] Vaginal bleeding may indicate a problem. […] If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.
#59 Management of Stillbirth | ACOG
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2020/03/management-of-stillbirth
The method and timing of delivery after a stillbirth depend on the gestational age at which the death occurred, maternal obstetric history (eg, previous hysterotomy), and maternal preference. […] Options for delivery of the stillborn fetus typically include dilation and evacuation or induction of labor. […] Induction of labor for an indication of late-term and postterm pregnancy is recommended after 42 0/7 weeks of gestation and can be considered at or after 41 weeks 0/7 days of gestation. […] The decision to proceed with early delivery to prevent stillbirth must incorporate an understanding of the increased risks of maternal and neonatal complications compared with the potential benefits.
#60 Management of Stillbirth | ACOG
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2020/03/management-of-stillbirth
The method and timing of delivery after a stillbirth depend on the gestational age at which the death occurred, maternal obstetric history (eg, previous hysterotomy), and maternal preference. […] Options for delivery of the stillborn fetus typically include dilation and evacuation or induction of labor. […] Induction of labor for an indication of late-term and postterm pregnancy is recommended after 42 0/7 weeks of gestation and can be considered at or after 41 weeks 0/7 days of gestation. […] The decision to proceed with early delivery to prevent stillbirth must incorporate an understanding of the increased risks of maternal and neonatal complications compared with the potential benefits.
#61 Management of Stillbirth | ACOG
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2020/03/management-of-stillbirth
The method and timing of delivery after a stillbirth depend on the gestational age at which the death occurred, maternal obstetric history (eg, previous hysterotomy), and maternal preference. […] Options for delivery of the stillborn fetus typically include dilation and evacuation or induction of labor. […] Induction of labor for an indication of late-term and postterm pregnancy is recommended after 42 0/7 weeks of gestation and can be considered at or after 41 weeks 0/7 days of gestation. […] The decision to proceed with early delivery to prevent stillbirth must incorporate an understanding of the increased risks of maternal and neonatal complications compared with the potential benefits.
#62 Management of Stillbirth | ACOG
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2020/03/management-of-stillbirth
The method and timing of delivery after a stillbirth depend on the gestational age at which the death occurred, maternal obstetric history (eg, previous hysterotomy), and maternal preference. […] Options for delivery of the stillborn fetus typically include dilation and evacuation or induction of labor. […] Induction of labor for an indication of late-term and postterm pregnancy is recommended after 42 0/7 weeks of gestation and can be considered at or after 41 weeks 0/7 days of gestation. […] The decision to proceed with early delivery to prevent stillbirth must incorporate an understanding of the increased risks of maternal and neonatal complications compared with the potential benefits.
#63 Stillbirth prevention
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/stillbirth-prevention
About one stillbirth occurs every 16 seconds, for a total of an estimated 2 million stillborn babies per year according to the latest WHO and UNICEF estimates. More than 40% of stillbirths occur during labour and birth and are preventable with high quality care during pregnancy and birth. WHO, UNICEF and other partners have called for a renewed commitment to end preventable stillbirths by 2030. The Every Newborn Action Plan includes a global target for stillbirth reduction that all countries achieve a stillbirth rate of 12 or fewer per 1000 total births by 2030, which was adopted in the Global Strategy for Womens, Childrens, and Adolescents Health 2016-2030. This will require working toward the ENAP stillbirth targets, the ENAP coverage targets to close the equity gap within countries, meeting antenatal and intrapartum quality care targets, achieve consensus on bereavement care and materials, and take global action to reduce the stigma around stillbirth. […] To attain this ambitious target, WHO is committed to: Increase the understanding of stillbirth, Reduce stigma, taboo and misconception, Set national and local stillbirth reduction targets, Strengthen health systems to provide high-quality care.
#64 What Australia Could Teach the U.S. About Reducing Stillbirths â ProPublica
https://www.propublica.org/article/what-australia-could-teach-america-about-reducing-stillbirths
Australia has emerged as a global leader in the effort to lower the number of babies that die before taking their first breaths. […] Stillbirth prevention is embedded in the nations health care system, supported by its doctors, midwives and nurses, and touted by its politicians. […] In 2017, funding from the Australian government established a groundbreaking center for research into stillbirths. […] By 2020, the country had adopted a national stillbirth plan, which combines the efforts of health care providers and researchers, bereaved families and advocacy groups, and lawmakers and government officials, all in the name of reducing stillbirths and supporting families. […] As part of that plan, researchers and advocates teamed up to launch a public awareness campaign. […] Australias goal, which has been complicated by the pandemic, is to, by 2025, reduce the countrys rate of stillbirths after 28 weeks by 20% from its 2020 rate.
#65 What Australia Could Teach the U.S. About Reducing Stillbirths â ProPublica
https://www.propublica.org/article/what-australia-could-teach-america-about-reducing-stillbirths
The most significant development came in 2019, when the Stillbirth Centre of Research Excellence the headquarters for Australias stillbirth-prevention efforts launched the core of its strategy, a checklist of five evidence-based priorities known as the Safer Baby Bundle. […] Officials estimate that at least half of all births in the country are covered by maternity services that have adopted the bundle, which focuses on preventing stillbirths after 28 weeks. […] The bundle gives doctors and midwives structure and uniform guidance, she said, and takes stillbirth out of the shadows. […] In addition to the Safer Baby Bundle, the national plan also calls for raising awareness and reducing racial disparities. […] The U.S. is not pulling its weight in relation either to our burden or to the resources that we have at our disposal.
#66 What Australia Could Teach the U.S. About Reducing Stillbirths â ProPublica
https://www.propublica.org/article/what-australia-could-teach-america-about-reducing-stillbirths
The most significant development came in 2019, when the Stillbirth Centre of Research Excellence the headquarters for Australias stillbirth-prevention efforts launched the core of its strategy, a checklist of five evidence-based priorities known as the Safer Baby Bundle. […] Officials estimate that at least half of all births in the country are covered by maternity services that have adopted the bundle, which focuses on preventing stillbirths after 28 weeks. […] The bundle gives doctors and midwives structure and uniform guidance, she said, and takes stillbirth out of the shadows. […] In addition to the Safer Baby Bundle, the national plan also calls for raising awareness and reducing racial disparities. […] The U.S. is not pulling its weight in relation either to our burden or to the resources that we have at our disposal.
#67 Preventing stillbirth | Australian Government Department of Health and Aged Care
https://www.health.gov.au/topics/pregnancy-birth-and-baby/birth-and-maternity-services/preventing-stillbirth
Stillbirth affects 6 families every day. Our national plan aims to reduce the number of stillbirths in Australia. It also aims to ensure families affected by stillbirth receive respectful and supportive bereavement care. […] There is increasing evidence that some stillbirths are preventable. Some countries â including the United Kingdom, Northern Ireland and New Zealand â have successfully reduced stillbirth rates. […] We are working to reduce stillbirth through the National Stillbirth Action and Implementation Plan. […] The National Stillbirth Action and Implementation Plan is the first national plan to address stillbirth in Australia. […] The plan aims to reduce stillbirth rates in Australia by 20% or more by December 2025. […] We fund various initiatives to support the planâs goals, including: a new clinical care standard and updating guidelines for health professionals, support for state and territory governments to increase stillbirth autopsies and investigations, research into activities to prevent stillbirth education and awareness, support for affected families, national implementation of the Safer Baby Bundle. […] The Safer Baby Bundle provides information to maternity care providers and women to reduce the risk of stillbirth. It includes guidance for health professionals and resources for women.
#68 Maine CDC and Partners Expand Stillbirth Prevention Program | Department of Health and Human Services
https://www.maine.gov/dhhs/blog/maine-cdc-and-partners-expand-stillbirth-prevention-program-2024-03-20
The Maine Center for Disease Control and Prevention (Maine CDC) is partnering with Count the Kicks, an evidence-based stillbirth prevention program, to educate expectant parents about the importance of paying attention to their babys movements in the third trimester of pregnancy. […] Research shows that nearly 30% of stillbirths can be prevented when expectant parents are educated on how to monitor their babys movements once a day starting at 28 weeks. […] Evidence shows that a change in a babys movements in the third trimester is an early red flag. […] Research shows that the Count the Kicks campaign helped lower the stillbirth rate in Iowa by more than 30% in the first 10 years of the prevention program at a time when Americas overall stillbirth rate remained stagnant.
#69
https://www.cbsnews.com/minnesota/news/new-brighton-woman-stillbirth-prevention/
Dr. Elizabeth Alabi, an OB-GYN with Hennepin Healthcare, said people of color, especially Black women, are at an increased risk for stillbirth. Other factors like obesity, diabetes and other health conditions heighten risk, too. […] Alabi advises people thinking about pregnancy to get preconception counseling to assess health issues that could affect pregnancy to optimize maternal health. Prenatal care and visits to a physician are also essential. […] But at home, expectant parents should monitor fetal movements, she added. Duffy works with „Count the Kicks,” a nonprofit educating parents about this that provides a free app that helps keep track of the frequency. […] „Your baby has a pattern, and so if you’re not feeling that, if that pattern isn’t happening or like a red flag is going off, those are things that you need to talk to your provider about,” Alabi said.
#70 Congress to vote on Rep. Hinsonâs stillbirth prevention bill
https://www.kcrg.com/2024/05/14/congress-vote-rep-hinsons-stillbirth-prevention-bill/
Congresswoman Ashley Hinsons bill could allow state departments of public health to use federal grants to educate women on stillbirth prevention. […] An estimated 20,000 pregnancies each year, end in stillbirth. One out of every four stillbirths can be prevented. […] Hinson believes that the legislation could help save lives. If women know hey I need to be monitoring how often my baby kicks. I need to make sure that if somethings wrong I actually am going to the doctor. So thats what this bill is about. Its about saving lives and helping to support women and families, Hinson said. […] The Des Moines-based maternal health organization, Healthy Birthday, led the efforts for the legislation. Its awareness program encourages mothers to use a free app called Count the Kicks to count their babies movements in the third trimester of pregnancy. Any significant change to the babies number of kicks each day could signal that the baby is in distress. […] Since the campaign began, Iowas stillbirth rate has fallen 32 percent, according to the nonprofit.
#71
https://www.dsmpartnership.com/news-media/blog/iowa-led-stillbirth-prevention-bill-passes-us-house-shortly-after-dmdc-trip
Recent reports and data suggest that further reduction in the incidence of stillbirth is possible, highlighting that nearly 25% of stillbirths are potentially preventable. […] The Count the Kicks program has shown promise in addressing racial disparities in birth outcomes. In the first 5 years of the program, the stillbirth rate for Black families in Iowa went down 39%. […] The Maternal and Child Health Stillbirth Prevention Act provides both clarity and a vital call to action from Congress to state health departments across the nation that they can and should use a portion of the existing $2.6 billion of Title V Block Grant funding to prevent stillbirth. […] Currently fewer than 20 state health departments are using a portion of these existing funds to address stillbirth, leaving expectant parents in most U.S. states and territories more vulnerable to stillbirth. This clarification will support stillbirth prevention activities, thereby helping to save the lives of mothers and babies. […] Our organization estimates more than 6,000 babies will be saved each year from preventable stillbirth once all 50 states adopt proven stillbirth prevention efforts.
#72 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#73 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#74 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#75 Stillbirth Prevention Act – Healthy Birth Day, Inc.
https://healthybirthday.org/advocacy/stillbirth-prevention-act/
Healthy Birth Day, Inc., the nonprofit organization that created the Count the Kicks stillbirth prevention program, is proud to be the primary stakeholder of The Maternal and Child Health Stillbirth Prevention Act, which was signed by President Biden on July 12, 2024. […] This is a critical piece of legislation that adds stillbirth and stillbirth prevention to Title V of the Social Security Act something that has been lacking since the introduction of Title V funding back in 1935. […] The Maternal and Child Health Stillbirth Prevention Act was a bipartisan, bicameral bill. […] The Biden-Harris Administration hosted a panel discussion on stillbirth at the White House complex on July 8, 2024, to increase awareness about its efforts to address the crisis of stillbirth in the U.S. […] On this day we were able to tell maternal health leaders at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Human Resources Services Administration (HRSA) what is possible when we invest in stillbirth prevention, and urge them to do more.
#76 Stillbirth Prevention Act – Healthy Birth Day, Inc.
https://healthybirthday.org/advocacy/stillbirth-prevention-act/
Healthy Birth Day, Inc., the nonprofit organization that created the Count the Kicks stillbirth prevention program, is proud to be the primary stakeholder of The Maternal and Child Health Stillbirth Prevention Act, which was signed by President Biden on July 12, 2024. […] This is a critical piece of legislation that adds stillbirth and stillbirth prevention to Title V of the Social Security Act something that has been lacking since the introduction of Title V funding back in 1935. […] The Maternal and Child Health Stillbirth Prevention Act was a bipartisan, bicameral bill. […] The Biden-Harris Administration hosted a panel discussion on stillbirth at the White House complex on July 8, 2024, to increase awareness about its efforts to address the crisis of stillbirth in the U.S. […] On this day we were able to tell maternal health leaders at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Human Resources Services Administration (HRSA) what is possible when we invest in stillbirth prevention, and urge them to do more.
#77 Stillbirth Prevention Act – Healthy Birth Day, Inc.
https://healthybirthday.org/advocacy/stillbirth-prevention-act/
Healthy Birth Day, Inc., the nonprofit organization that created the Count the Kicks stillbirth prevention program, is proud to be the primary stakeholder of The Maternal and Child Health Stillbirth Prevention Act, which was signed by President Biden on July 12, 2024. […] This is a critical piece of legislation that adds stillbirth and stillbirth prevention to Title V of the Social Security Act something that has been lacking since the introduction of Title V funding back in 1935. […] The Maternal and Child Health Stillbirth Prevention Act was a bipartisan, bicameral bill. […] The Biden-Harris Administration hosted a panel discussion on stillbirth at the White House complex on July 8, 2024, to increase awareness about its efforts to address the crisis of stillbirth in the U.S. […] On this day we were able to tell maternal health leaders at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Human Resources Services Administration (HRSA) what is possible when we invest in stillbirth prevention, and urge them to do more.
#78 Maternal and Child Health Stillbirth Prevention Act Becoming Law | March of Dimes
https://www.marchofdimes.org/about/news/maternal-and-child-health-stillbirth-prevention-act-becoming-law
New legislation is part of a longer-term solution towards the prevention and reduction of incidences of stillbirth in the United States […] The Maternal and Child Health Stillbirth Prevention Act, which passed in the House and was unanimously approved by the Senate, will add stillbirth and stillbirth prevention to Title V of the Social Security Act clarifying that these funds can be used for stillbirth education and prevention activities. This legislation calls for comprehensive, evidence-based programs and activities aimed at reducing the incidence of stillbirth including: Tracking and raising awareness of fetal movements, Improving birth timing for pregnant individuals with risk factors, Encouraging safe sleeping positions for pregnant individuals, Screening and surveillance for fetal growth restriction, Promoting smoking cessation among pregnant individuals, Supporting community-based programs that provide home visits or other types of support […] March of Dimes remains committed to advocating for policies that support the health of moms and babies like the SHINE for Autumn Act (S. 2647/H.R. 5012), which aims to further address the issue of stillbirth by improving data collection and research.
#79 Stillbirth Prevention Act – Healthy Birth Day, Inc.
https://healthybirthday.org/advocacy/stillbirth-prevention-act/
Healthy Birth Day, Inc., the nonprofit organization that created the Count the Kicks stillbirth prevention program, is proud to be the primary stakeholder of The Maternal and Child Health Stillbirth Prevention Act, which was signed by President Biden on July 12, 2024. […] This is a critical piece of legislation that adds stillbirth and stillbirth prevention to Title V of the Social Security Act something that has been lacking since the introduction of Title V funding back in 1935. […] The Maternal and Child Health Stillbirth Prevention Act was a bipartisan, bicameral bill. […] The Biden-Harris Administration hosted a panel discussion on stillbirth at the White House complex on July 8, 2024, to increase awareness about its efforts to address the crisis of stillbirth in the U.S. […] On this day we were able to tell maternal health leaders at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Human Resources Services Administration (HRSA) what is possible when we invest in stillbirth prevention, and urge them to do more.
#80 Merkley’s Maternal and Child Health Stillbirth Prevention Act signed into law – KTVZ
https://ktvz.com/news/government-politics/2024/07/13/merkleys-maternal-and-child-health-stillbirth-prevention-act-signed-into-law/
Recent reports and data suggest the United States can and must do more to prevent stillbirth, highlighting that at least 25 percent of stillbirths are potentially preventable. […] The Maternal and Child Health Stillbirth Prevention Act passed the Senate unanimously and passed the House with a bipartisan vote of 408-3.
#81 Congress Passes Maternal and Child Health Stillbirth Prevention Act â ProPublica
https://www.propublica.org/article/maternal-child-health-stillbirth-prevention-act-congress-passes
This does not have to be a silent crisis anymore, she said, adding that several thousand lives can be saved every year. […] The new legislation includes examples of services that states can implement, many of which have been adopted in other countries. Programs include tracking fetal movement, improving the timing of birth when risk factors are present, encouraging safe sleep positions during pregnancy, supporting pregnant patients to stop smoking and monitoring for signs that the fetus is not growing as expected. […] The bills passage, she said, means stillbirth is finally being recognized for the crisis that it is in America. […] Now we know better, and we must do better, she said. The impact will affect families immediately and for generations to come. […] Isaac traveled to Washington, D.C., last month with Price and other stillbirth families to advocate for the bills passage and a second bipartisan stillbirth bill pending in Congress. That bill, the Stillbirth Health Improvement and Education (SHINE) for Autumn Act, proposes $45 million over the next five years for improving data collection, stillbirth research, awareness and education, as well as supporting training for fetal autopsies.
#82 Congress Passes Maternal and Child Health Stillbirth Prevention Act â ProPublica
https://www.propublica.org/article/maternal-child-health-stillbirth-prevention-act-congress-passes
This does not have to be a silent crisis anymore, she said, adding that several thousand lives can be saved every year. […] The new legislation includes examples of services that states can implement, many of which have been adopted in other countries. Programs include tracking fetal movement, improving the timing of birth when risk factors are present, encouraging safe sleep positions during pregnancy, supporting pregnant patients to stop smoking and monitoring for signs that the fetus is not growing as expected. […] The bills passage, she said, means stillbirth is finally being recognized for the crisis that it is in America. […] Now we know better, and we must do better, she said. The impact will affect families immediately and for generations to come. […] Isaac traveled to Washington, D.C., last month with Price and other stillbirth families to advocate for the bills passage and a second bipartisan stillbirth bill pending in Congress. That bill, the Stillbirth Health Improvement and Education (SHINE) for Autumn Act, proposes $45 million over the next five years for improving data collection, stillbirth research, awareness and education, as well as supporting training for fetal autopsies.
#83 What Australia Could Teach the U.S. About Reducing Stillbirths â ProPublica
https://www.propublica.org/article/what-australia-could-teach-america-about-reducing-stillbirths
The day after the reports release, the Australian government announced that it would develop a national plan and pledged $7.2 million in funding for prevention. […] Many in Australia see Keneallys first speech as senator, in 2018, as the turning point for the countrys fight for stillbirth prevention. […] The improvements it recommends for bereavement care are already gaining global attention. […] The lack of U.S. research on the issue has made some cautious to adopt the bundle, Silver said, but it is clear the U.S. can and should do more. […] After more than 30 years of working on stillbirth prevention, Silver said the U.S. may be at a turning point. […] More doctors are affirming that stillbirths are not inevitable. […] The second bill, the Stillbirth Health Improvement and Education for Autumn Act, includes features that also appeared in Australias plan, such as improving data, increasing awareness and providing support for autopsies.
#84 Preventing stillbirth | Australian Government Department of Health and Aged Care
https://www.health.gov.au/topics/pregnancy-birth-and-baby/birth-and-maternity-services/preventing-stillbirth
Stillbirth affects 6 families every day. Our national plan aims to reduce the number of stillbirths in Australia. It also aims to ensure families affected by stillbirth receive respectful and supportive bereavement care. […] There is increasing evidence that some stillbirths are preventable. Some countries â including the United Kingdom, Northern Ireland and New Zealand â have successfully reduced stillbirth rates. […] We are working to reduce stillbirth through the National Stillbirth Action and Implementation Plan. […] The National Stillbirth Action and Implementation Plan is the first national plan to address stillbirth in Australia. […] The plan aims to reduce stillbirth rates in Australia by 20% or more by December 2025. […] We fund various initiatives to support the planâs goals, including: a new clinical care standard and updating guidelines for health professionals, support for state and territory governments to increase stillbirth autopsies and investigations, research into activities to prevent stillbirth education and awareness, support for affected families, national implementation of the Safer Baby Bundle. […] The Safer Baby Bundle provides information to maternity care providers and women to reduce the risk of stillbirth. It includes guidance for health professionals and resources for women.
#85 Preventing stillbirth | Australian Government Department of Health and Aged Care
https://www.health.gov.au/topics/pregnancy-birth-and-baby/birth-and-maternity-services/preventing-stillbirth
Stillbirth affects 6 families every day. Our national plan aims to reduce the number of stillbirths in Australia. It also aims to ensure families affected by stillbirth receive respectful and supportive bereavement care. […] There is increasing evidence that some stillbirths are preventable. Some countries â including the United Kingdom, Northern Ireland and New Zealand â have successfully reduced stillbirth rates. […] We are working to reduce stillbirth through the National Stillbirth Action and Implementation Plan. […] The National Stillbirth Action and Implementation Plan is the first national plan to address stillbirth in Australia. […] The plan aims to reduce stillbirth rates in Australia by 20% or more by December 2025. […] We fund various initiatives to support the planâs goals, including: a new clinical care standard and updating guidelines for health professionals, support for state and territory governments to increase stillbirth autopsies and investigations, research into activities to prevent stillbirth education and awareness, support for affected families, national implementation of the Safer Baby Bundle. […] The Safer Baby Bundle provides information to maternity care providers and women to reduce the risk of stillbirth. It includes guidance for health professionals and resources for women.
#86 Stillbirth prevention
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/stillbirth-prevention
About one stillbirth occurs every 16 seconds, for a total of an estimated 2 million stillborn babies per year according to the latest WHO and UNICEF estimates. More than 40% of stillbirths occur during labour and birth and are preventable with high quality care during pregnancy and birth. WHO, UNICEF and other partners have called for a renewed commitment to end preventable stillbirths by 2030. The Every Newborn Action Plan includes a global target for stillbirth reduction that all countries achieve a stillbirth rate of 12 or fewer per 1000 total births by 2030, which was adopted in the Global Strategy for Womens, Childrens, and Adolescents Health 2016-2030. This will require working toward the ENAP stillbirth targets, the ENAP coverage targets to close the equity gap within countries, meeting antenatal and intrapartum quality care targets, achieve consensus on bereavement care and materials, and take global action to reduce the stigma around stillbirth. […] To attain this ambitious target, WHO is committed to: Increase the understanding of stillbirth, Reduce stigma, taboo and misconception, Set national and local stillbirth reduction targets, Strengthen health systems to provide high-quality care.
#87 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Around half of the twomillion stillbirths occurring worldwide each year are preventable. This review compiles the most up-to-date evidence to inform stillbirth prevention. Many general maternal health interventions also reduce the risk of stillbirth, for example, antenatal care attendance. This review focuses on specific aspects of care: glucose metabolism, targeted aspirin prophylaxis, clotting and immune disorders, sleep positions, fetal movement monitoring, and preconception and interconception health. […] Action must be taken with the evidence available now, in healthcare settings with high or low resources, to reduce stillbirths and improve training and care. […] Prevention efforts are essential but, equally as important, all parents who experience a stillborn baby must receive high quality, supportive bereavement care.
#88 New approaches to stillbirth prevention | The Centre of Research Excellence in Stillbirth
https://stillbirthcre.org.au/researchers-clinicians/research-program-areas/new-approaches-to-stillbirth-prevention/
Developing new approaches for identifying women at increased risk of stillbirth. […] Novel tests to improve antenatal detection of women at increased risk of stillbirth are needed. […] By assessing the function of the placenta, it may be possible to predict which babies have a greater chance of stillbirth. We may then be able to intervene before stillbirth occurs. […] Therefore, detecting babies who have an increased chance of experiencing distress during labour may help to reduce both stillbirth and childhood disability. […] A national collaboration has been established to identify novel placental biomarkers for pre-clinical testing.
#89 New approaches to stillbirth prevention | The Centre of Research Excellence in Stillbirth
https://stillbirthcre.org.au/researchers-clinicians/research-program-areas/new-approaches-to-stillbirth-prevention/
Developing new approaches for identifying women at increased risk of stillbirth. […] Novel tests to improve antenatal detection of women at increased risk of stillbirth are needed. […] By assessing the function of the placenta, it may be possible to predict which babies have a greater chance of stillbirth. We may then be able to intervene before stillbirth occurs. […] Therefore, detecting babies who have an increased chance of experiencing distress during labour may help to reduce both stillbirth and childhood disability. […] A national collaboration has been established to identify novel placental biomarkers for pre-clinical testing.
#90 New approaches to stillbirth prevention | The Centre of Research Excellence in Stillbirth
https://stillbirthcre.org.au/researchers-clinicians/research-program-areas/new-approaches-to-stillbirth-prevention/
Developing new approaches for identifying women at increased risk of stillbirth. […] Novel tests to improve antenatal detection of women at increased risk of stillbirth are needed. […] By assessing the function of the placenta, it may be possible to predict which babies have a greater chance of stillbirth. We may then be able to intervene before stillbirth occurs. […] Therefore, detecting babies who have an increased chance of experiencing distress during labour may help to reduce both stillbirth and childhood disability. […] A national collaboration has been established to identify novel placental biomarkers for pre-clinical testing.
#91 New approaches to stillbirth prevention | The Centre of Research Excellence in Stillbirth
https://stillbirthcre.org.au/researchers-clinicians/research-program-areas/new-approaches-to-stillbirth-prevention/
Developing new approaches for identifying women at increased risk of stillbirth. […] Novel tests to improve antenatal detection of women at increased risk of stillbirth are needed. […] By assessing the function of the placenta, it may be possible to predict which babies have a greater chance of stillbirth. We may then be able to intervene before stillbirth occurs. […] Therefore, detecting babies who have an increased chance of experiencing distress during labour may help to reduce both stillbirth and childhood disability. […] A national collaboration has been established to identify novel placental biomarkers for pre-clinical testing.
#92 Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078228/
Possible benefit for fetal loss or death: insecticide-treated antimalarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low certainty). […] Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high certainty), training versus not training traditional birth attendants in rural populations of low and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate certainty). […] While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. […] Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.
#93 Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy | BMC Pregnancy and Childbirth | Full Text
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-9-S1-S4
An estimated two-thirds of the world’s 3.2 million stillbirths occur antenatally, prior to labour, and are often overlooked in policy and programs. Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth. […] Evidence for some newly recognised risk factors for stillbirth, including periodontal disease, suggests the need for large, appropriately designed randomised trials to test whether intervention can minimise these risks and prevent stillbirths. Existing evidence strongly supports infection control measures, including syphilis screening and treatment and malaria prophylaxis in endemic areas, for preventing antepartum stillbirths. These interventions should be incorporated into antenatal care programs based on attributable risks and burden of disease.
#94 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] Potential modifiable risk factors for stillbirth include short birth interval, obesity, tobacco smoking, illicit drug use, advanced maternal age, and non-attendance at antenatal care. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now.
#95 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias. […] In a case-control study comparing 153 individuals who had experienced stillbirth with 480 people with an ongoing pregnancy or live delivery, those who had a stillbirth were much more likely to have had reduced fetal movements in the preceding two weeks. […] Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Vaccination may reduce stillbirth risk; a meta-analysis of 23 observational studies showed marginally lower stillbirth risk among individuals vaccinated against covid-19. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now. Two examples that we highlight are improving identification and management diabetes in pregnancy and prophylactic aspirin administration.
#96 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
A 2013 systematic review of randomised controlled trials showed reduced pre-eclampsia, perinatal death, and fetal growth restriction among individuals at high risk commenced on aspirin before 16 weeks. […] Few studies examining aspirin use in pregnancy are powered to detect stillbirth risk reduction. […] Risk stratification is undergoing debate, and international guidelines inconsistently describe target populations for prophylactic aspirin. […] Gestational diabetes mellitus is glucose intolerance diagnosed during pregnancy. This disorder is associated with adverse pregnancy outcomes; fetal macrosomia, shoulder dystocia, neonatal hypoglycaemia, congenital abnormalities, maternal hypertensive disease, future type two diabetes mellitus, and antepartum stillbirth. […] The pathogenesis of stillbirth associated with gestational diabetes mellitus is unclear, however, glucose dysmetabolism critically impacts placental development and function.
#97 Stillbirth: prevention and supportive bereavement care
https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/
Around half of the twomillion stillbirths occurring worldwide each year are preventable. This review compiles the most up-to-date evidence to inform stillbirth prevention. Many general maternal health interventions also reduce the risk of stillbirth, for example, antenatal care attendance. This review focuses on specific aspects of care: glucose metabolism, targeted aspirin prophylaxis, clotting and immune disorders, sleep positions, fetal movement monitoring, and preconception and interconception health. […] Action must be taken with the evidence available now, in healthcare settings with high or low resources, to reduce stillbirths and improve training and care. […] Prevention efforts are essential but, equally as important, all parents who experience a stillborn baby must receive high quality, supportive bereavement care.
#98 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias. […] In a case-control study comparing 153 individuals who had experienced stillbirth with 480 people with an ongoing pregnancy or live delivery, those who had a stillbirth were much more likely to have had reduced fetal movements in the preceding two weeks. […] Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Vaccination may reduce stillbirth risk; a meta-analysis of 23 observational studies showed marginally lower stillbirth risk among individuals vaccinated against covid-19. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now. Two examples that we highlight are improving identification and management diabetes in pregnancy and prophylactic aspirin administration.
#99 Stillbirth: prevention and supportive bereavement care | BMJ Medicine
https://bmjmedicine.bmj.com/content/2/1/e000262
The association between sleep position and stillbirth has been highlighted, although evidence is largely from case-control questionnaire studies, which are subject to recall bias. […] In a case-control study comparing 153 individuals who had experienced stillbirth with 480 people with an ongoing pregnancy or live delivery, those who had a stillbirth were much more likely to have had reduced fetal movements in the preceding two weeks. […] Overall, evidence is insufficient to show stillbirth prevention through fetal movement monitoring in high income countries. […] An increased rate of stillbirth among mothers who are not vaccinated and acquire a covid-19 infection during pregnancy has been described across different countries. […] Vaccination may reduce stillbirth risk; a meta-analysis of 23 observational studies showed marginally lower stillbirth risk among individuals vaccinated against covid-19. […] Several evidence based interventions could and should be implemented to reduce stillbirth incidence now. Two examples that we highlight are improving identification and management diabetes in pregnancy and prophylactic aspirin administration.
#100 Stillbirth prevention
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/stillbirth-prevention
About one stillbirth occurs every 16 seconds, for a total of an estimated 2 million stillborn babies per year according to the latest WHO and UNICEF estimates. More than 40% of stillbirths occur during labour and birth and are preventable with high quality care during pregnancy and birth. WHO, UNICEF and other partners have called for a renewed commitment to end preventable stillbirths by 2030. The Every Newborn Action Plan includes a global target for stillbirth reduction that all countries achieve a stillbirth rate of 12 or fewer per 1000 total births by 2030, which was adopted in the Global Strategy for Womens, Childrens, and Adolescents Health 2016-2030. This will require working toward the ENAP stillbirth targets, the ENAP coverage targets to close the equity gap within countries, meeting antenatal and intrapartum quality care targets, achieve consensus on bereavement care and materials, and take global action to reduce the stigma around stillbirth. […] To attain this ambitious target, WHO is committed to: Increase the understanding of stillbirth, Reduce stigma, taboo and misconception, Set national and local stillbirth reduction targets, Strengthen health systems to provide high-quality care.
#101 How to Prevent Stillbirth: Reducing the RisksCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice
https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/preventing-stillbirth
If you feel that something is wrong, or if you are worried about the baby, call your midwife or doctor to talk about it. Don’t worry if you’ve talked about it before and don’t be concerned about whether you’re wasting anyone’s time. This is your pregnancy and it’s important to trust your own instincts if you feel something isn’t right. […] Unfortunately, itâs often not possible to know the cause of a stillbirth and it canât always be prevented. But there are things you can do to reduce your risk. These include: not smoking; avoiding alcohol, caffeine and drugs; attending all your antenatal appointments; making sure youâre a healthy weight before trying to get pregnant; protecting yourself against infections; avoiding certain foods; looking out for any red-flag symptoms such as stomach pain, vaginal bleeding and itching, and seeking help from your midwife immediately; monitoring your babyâs movements and letting your midwife know straightaway if youâre worried about any reduction; going to sleep on your side, not on your back; managing any pre-existing medical conditions (this may mean you have to change or stop your medications).