One of the most dreaded complications in obstetrics is a stillbirth that is defined as the absence of life upon delivery of the baby. There are approximately 3million stillbirths that occur each year globally and one-half million in the U.S. In developing countries, the most common reasons of stillbirths were prolonged labor, pre-eclampsia and infections whereas in the U.S., the most common causes are abnormal genes, abnormal growth (aka growth restriction) and maternal diseases. According to medical studies, unexplained fetal loss is the most common reason for stillbirths that occur after 28 weeks. Risk factors for stillbirth include women who have infections, abnormal chromosomes, genetic disorders and umbilical cord complications. Race and socioeconomics also play a role. Black women have twice the risk of having a stillbirth as Caucasian women. Smoking and advanced maternal age also poses an increased risk.
Until recently, there are no screening tests available to see if a woman was carrying a baby at risk for stillbirth. However, a medical study presented at a conference reported that stillbirths can now be predicted using a second trimester screening test that uses a marker in the blood called Inhibin A. The study involved approximately 400 women who had experienced stillbirths and all of them had an increase in Ihibin A. Inhibin A is used to screen for Down syndrome in the second trimester. The implication for this new discovery is huge. Women who have abnormal Inibin A levels could be monitored closely for appropriate fetal growth since fetal growth restriction has been implicated in 40% of stillbirth cases. Dr. George Saade, the Principal Investigator of the study who is associated with the University of Texas in Galveston, admits that more in-depth work needs to be done before Inihibin A becomes an official screening test. All babies deserve to live. We await Dr. Saade’s further studies with bated breath.
*This blog post was originally published at Dr. Linda Burke-Galloway*