(RxWiki News) Is it possible that the environment inside a woman's body may sometimes reflect what is going on in her life? How much could severe stress contribute to a stillbirth?
A group of researchers looked for answers by comparing women at the same hospitals who had stillbirths and live births. They interviewed the women and looked at their medical records.
The researchers found that one in five women who had stillbirths had recently experienced five or more major stressful life events. Among women who had surviving children, only one in 10 had experienced such a major life event.
"Attend all prenatal appointments."
The study, led by Carol J. R. Hogue, of the Department of Epidemiology at Emory University's Rollins School of Public Health in Atlanta, aimed to better understand possible causes of stillbirths, especially since the rate of stillbirths is twice as high among black women than among white women in the US.
The researchers focused on the births over a two-year period in 59 hospitals across five different regions throughout the US.
The study included 663 women who gave birth at least 20 weeks into pregnancy to a child who did not survive. As a comparison group, the study also included 1,932 women who gave birth to surviving children in the same hospitals.
The women who had surviving children were more likely to be married, white, privately insured, of normal weight, non-diabetic and between ages 20 and 39 than the women who had stillbirths.
Twice as many women who had stillbirths (10.2 percent) had a history of miscarriages compared those who had live births (5.2 percent).
Among the women who had stillbirths, there was also a much higher rate of past stillbirth (6.7 percent) or past pregnancy with multiples (6.4 percent) than among the women with live births (1.4 percent past stillbirth and 1.9 percent previous multiples pregnancy).
The researchers conducted an interview with the women and reviewed their medical records, lab work for their placentas and data about autopsies on the babies who did not survive.
The interviews asked the women about 13 significant life events that are known to cause severe stress or adversity in individuals and whether any of them had occurred to the women within the 12 months before their delivery.
The events fell into four different categories: financial (job loss, unable to pay bills), emotional (homeless, partner or self went to jail), traumatic (death or serious illness of loved one) and partner-related (divorce, fights, substance abuse).
The researchers found that the more significant live events the women reported of any of the four types, the more likely it was that they had had a stillbirth.
While 75 percent of the women who delivered a live infant had experienced at least one significant life event, 82 percent of the women with stillbirths reported at least one of these events.
Women who reported four or more significant life events were more than twice as likely to have had a stillbirth as women reporting fewer events.
The two events that showed the strongest link to stillbirths were the inability to pay bills and physical fights with a partner.
Among women who had surviving children, 17.8 percent reported having a lot of bills they couldn't pay, compared to 26.9 percent of the women who had stillbirths.
While 3.5 percent of the women who had surviving children had been in a fight with a partner, twice as many (7.6 percent) women with stillbirths reporting being in a fight with their partner.
Other significant life events strongly associated with stillbirth were going to jail or having a partner go to jail or having a partner who didn't want a pregnancy.
Among white women, having a partner who did not want a pregnancy was linked to a three times higher risk for a stillbirth. In terms of race/ethnicity, black women were more likely to report experiencing significant life events than white or Hispanic women.
The study was published March 26 in the American Journal of Epidemiology. The research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institutes of Health. The authors declared no conflicts of interest.