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To estimate the risk of recurrence of stillbirth in a subsequent pregnancy.
We studied in retrospect a nationwide birth cohort in the Netherlands from 1999 to 2007. In total, records of 252.827 women with a singleton birth in a first pregnancy could be linked to records of their second pregnancy using data obtained from the national Perinatal Registry. Stillbirth was defined as antepartum or intrapartum fetal death from 22 weeks of gestation. Fetal deaths associated with a major congenital anomaly were excluded. Small for gestational age (SGA) was defined as birthweight <10th percentile.
Of 252.827 first pregnancies, 2058 pregnancies ended in a stillbirth (8.1 per 1000). At the subsequent pregnancy there were 815 stillbirths. For women whose first pregnancy resulted in a stillbirth, the rate of stillbirth in their subsequent pregnancy was 5.8 per 1000, versus 3.2 per 1000 for women without a stillbirth in their first pregnancy (OR 1.8 [95% CI 1.02-3.60]. After adjustment for maternal age, ethnicity, social-economic status and SGA in the first pregnancy the risk was 2.4 [95% CI 1.32-4.21]). Highest risk of recurrence of stillbirth occurred in women with a history of a stillbirth between 22 and 28 weeks of gestation during the first pregnancy (15.0 per 1000, OR 2.54 [95% CI 0.72-8.98]). Women with a history of a stillbirth ≥ 37 weeks of gestation appeared to have no risk of recurrence (1.1 per 1000, OR 0.37 [95% CI 0.05-2.64]). This might be related to the 68% induction of labor rate for women with a history of stillbirth ≥ 37 weeks of gestation was, versus 22% for women without a history of stillbirth.
Women with a prior stillbirth have a higher risk of recurrence in their next pregnancy. This risk was mainly observed when stillbirth had occurred in early gestation (22-28 weeks). The absence of this association in late pregnancy might be due to more inductions of labour.
1Recurrence risk of stillbirth in a second pregnancy by gestational age