Researchers from the University of Texas Medical Branch and the Stillbirth Collaborative Research Network have identified a link between stillbirth and either restricted or excessive fetal growth. Findings from the study are online in the April 22 issue of PLOS Medicine.
Using a new approach developed by the network to estimate gestational age in stillborn babies, Dr. Radek Bukowski, lead researcher and professor of obstetrics and gynecology at UTMB, and his colleagues evaluated 663 stillbirths and 1932 live births that occurred over a two-and-a-half year period at 59 hospitals in five U.S. regions.
They found that fetuses whose growth was below normal had a three- to four-fold increased risk of stillbirth. Fetuses whose growth was above normal also had a two- to three-fold increased risk of being stillborn.
Fetuses who were at the most extreme ends of growth — those that fell below the 5th percentile or were above the 95th percentile for weight — had the highest risk for stillbirth. The findings suggest that, contrary to current practices, obstetricians should place more emphasis on identifying fetuses that fall into those two categories when offering prevention strategies to pregnant women.
"When accounting for time of death, both low and high birth weights were associated with stillbirth in our study," said the study's authors in a joint statement.
"We hope that the findings of this study will initiate a process leading to a new approach to prevention of stillbirth," said Bukowski.
Other authors of the study include Nellie I. Hansen, Marian Willinger, Dr. Uma M. Reddy, Corette B. Parker, Dr. Halit Pinar, Dr. Robert M. Silver, Dr. Donald J. Dudley, Dr. Barbara J. Stoll, Dr. George R. Saade, Dr. Matthew A. Koch, Carol Hogue, Dr. Michael W. Varner, Dr. Deborah L. Conway, Dr. Donald Coustan and Dr. Robert L. Goldenberg for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network.
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Journal
PLoS Medicine