Stillbirth and advanced pregnancy age – is there an increased risk?

This study investigated if there is a link between gestational age (the number of weeks of pregnancy) and neonatal death (ND) or stillbirth (SB).

They found that there was a greater risk of SB at 41 weeks. 

Stillbirth (SB) continues to be an issue for many women. Although pregnancy care has improved vastly over the years, the rates of SB have not improved. It is unclear why this is the case. Prolonged pregnancy is a risk factor for SB. A neonate (baby) is considered full-term if born at 37-40 weeks gestation. 

Although SB rates are higher after full-term, there is a concern that pre-term delivery might increase the risk of neonatal death (ND). It is unclear if the risks of SB or ND is greater with advancing gestational age.

This study included data from over 15 million pregnancies. In this dataset, 17,830 SBs and 2,348 NDs were reported. The authors compared information on pregnancy outcomes including SB and ND. This was compared to the gestational age of the neonate. 

The risk of SB increased with advancing gestational age. The risk of SB at 42 weeks was 3.18 times higher than full-term. The risk of ND was similar at GA of 38-41 weeks. The risk of ND increased after 41 weeks. 

The authors concluded that there was a greater risk of SB at 41 weeks.

The data in this study was obtained over a period of 38 years. The standards of care have changed considerably over this time. Important information on individual pregnancies was not available for analysis. More investigation is needed.