Some time ago, I responded to a question about stillbirths and their possible relationship to SIDS. At that time, I indicated that there were many potential causes for stillbirth. These mechanisms for apparently sudden fetal death would thus be very different from any of the mechanisms thought to be pertinent to SIDS. I concluded at that time that it seemed best to continue considering stillbirth and SIDS as separate and unrelated.
Based on a study presented at our national pediatric research meetings in May, I would not like to summarize a different perspective. For this study from Norway, they reviewed almost 300 single still-births weighing at least 1.1 pounds and at least 23 weeks (full term 38-42 weeks). Of these, 75% were fully explained by the medical history and postmortem examination, but the other 25% remained unexplained. The risk for sudden unexpected intrauterine death (SUID) increased as age in weeks increased, and by full term age, the frequency was equal to that of explained causes of SUID. Significant risk factors for SUID included maternal age >25 years, >10 cigarettes/day compared to not smoking, and <10 years maternal education compared to >12 years. In summary, obstetricians can indeed identify a group of stillbirths that are unexpected and that remain unexplained. The closer to full term that a stillbirth occurs, the more likely that it will be SUID rather than an explained stillbirth. Although no mechanism for SUID have yet been studied, it is certainly logical to consider that any of the brainstem causes of SIDS that we think are important for SIDS may, for example, be equally important for SUID. These data also provide another reason why support groups should include stillbirths (especially all SUID) as well as all sudden, unexpected deaths in infancy (SUDI) in their programs. Carl E. Hunt, M.D., professor of pediatrics at Medical College of Ohio and Mercy Children’s Hospital. The entire article reporting on the SHIME study has been submitted for publication by an internationally respected medical journal..
Editor’s Note: Dr. Jason Collins has long known this fact and has been one of the few researchers in the U.S. to study full term stillbirth and its enigmas. Approximately 110 babies are stillborn in the U.S. every day— about 39,000 per year. Of those, about 60% are “unknown” cause of death.
Happiness lies for those who cry,
those who hurt, those who have searched,
and those who have tried,
for only they can appreciate the
importance of people who have touched their lives.
