One of the scariest things about getting pregnant again after a loss is the fear that it will happen again. And doctors, like the rest of us, being unable to predict the future, could not give us an answer. Recently, researchers at the University of Aberdeen sought to answer that question. For women who have had a previous stillbirth, are they at an increased risk of losing another child? And if so, exactly how much of an increased risk is there?

The researchers did a systematic review, which is where they seek to combine the results of multiple studies in order to get a bigger, and more accurate picture, of what is known about a topic. Using a variety of methods, they also seek to minimize bias in their selection of these studies, which was done well here. The result looks something like this:

forest

 

 

This is called a Forest Plot, and here’s how to read it. The solid, vertical line in the middle is the line of no effect. If women who had a previous stillbirth were no more likely than other women to have a stillbirth in their second pregnancy, we would expect to see all the horizontal lines cluster around this line. The horizontal lines from top to bottom are the individual studies looked at in this review. The odds are calculated for each study and shown compared to the line of no effect. Because all the studies, except the first one, Robson, are to the right of the line of no effect, this means that all the studies are showing that the likelihood of having a stillbirth when your first baby was stillborn is greater than for women whose first baby was born alive.

So the short version? If your first baby was stillborn, the chance that your second baby will be stillborn is about 5 times greater than it would be for the general population. Keep in mind, that’s still very good odds. But it does justify being closely monitored in this pregnancy and being a little quicker to take action if it appears things might be going wrong, particularly if the cause of your first loss is unknown. The research also was not able to separate the likelihood of a second stillbirth based on causes, but many, such as infection are not likely to happen again.

If you’d like to read more about this study, or share the full text with your doctor, you can find it at:

Lamont Kathleen, Scott Neil W, Jones Gareth T, Bhattacharya Sohinee. Risk of recurrent stillbirth: systematic review and meta-analysis BMJ. 2015; 350 :h3080

Forest plot reproduced as part of Creative Commons Licence: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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