Previous Stillbirth as a Predictor of Subsequent Perinatal Outcomes

A systematic review and meta-analysis has provided valuable insights into the relationship between previous stillbirth and perinatal outcomes in subsequent pregnancies. The analysis included 19 cohort studies encompassing a total of 4,855,153 participants. Among these, 28,322 women had a history of stillbirth and met the eligibility criteria for the study.

The findings highlight a significantly increased risk of adverse outcomes among women with a prior stillbirth compared with those who had previous live births. Specifically, these women were at higher risk of recurrent stillbirth, preterm birth, neonatal death, small for gestational age/intrauterine growth restriction, low birth weight, placental abruption, instrumental delivery, labor induction, and cesarean delivery—including both elective and emergency procedures. Conversely, women with a history of stillbirth were less likely to experience spontaneous labor. Notably, no significant association was observed between previous stillbirth and preeclampsia in subsequent pregnancies.

This comprehensive analysis underscores the importance of individualized counseling and close monitoring for women planning pregnancy after a stillbirth. By identifying the heightened risks, healthcare providers can better inform couples, optimize prenatal care, and implement strategies to improve maternal and neonatal outcomes in subsequent pregnancies.

Source:  American Journal of Obstetrics &Gynecology. 2024;231(2): 211 – 222