A history of stillbirth significantly raises the odds of it happening again. A large retrospective study found that individuals with a prior stillbirth had more than double the risk of recurrence — and if placental insufficiency was the cause, that risk jumped sixfold. Researchers say a thorough post-stillbirth evaluation, including placental pathology, is key to understanding and managing recurrence risk.
A history of stillbirth significantly raises the odds of it happening again — and the underlying cause matters a lot. A large retrospective study of over 77,000 individuals found that those who experienced a prior stillbirth had more than double the risk of recurrence in their next pregnancy compared to those with a prior live birth. When placental insufficiency was identified as the cause of the initial loss, the risk increased even further.
The study, published in the American Journal of Obstetrics & Gynecology, spanned 23 years at a single academic institution and used a multidisciplinary review process — including placental pathology, autopsy findings, and genetic testing — to determine the cause of each stillbirth. Placental insufficiency was identified using the Amsterdam criteria, looking for signs like villous infarction and decidual arteriopathy.
By the Numbers:
Why it matters: These findings underscore the critical importance of comprehensive stillbirth evaluation — including placental pathology and multidisciplinary review — to accurately assess recurrence risk and guide clinical management in subsequent pregnancies.
