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Pregnancy risk factors:
Previous miscarriage or stillbirth
What are the chances of having a second miscarriage or stillbirth?
Anyone who’s suffered a miscarriage or stillbirth during pregnancy knows how excruciating that loss can be. Women are often left with overwhelming feelings of sadness, anger and confusion. It takes time to heal both emotionally and physically after such a traumatic event, and it’s normal to have concerns about trying to get pregnant again.
In this article, we’ll discuss the overall risk factors for miscarriages and stillbirths, recurrent miscarriage and stillbirth statistics and potential causes, as well as ways to increase your chances of having a successful pregnancy.
Risk factors for miscarriages and stillbirths
Miscarriage risk factors
Miscarriage is defined as a sudden loss of pregnancy before 20 weeks. An estimated 10 to 20 percent of pregnancies end in miscarriage; however, some experts believe this estimate may be low because many women experience a miscarriage early on before they even know they’re pregnant.
The majority of miscarriages happen because the fetus isn’t developing normally, and there is nothing the mother can do to prevent it. In fact, about 50 percent of miscarriages are thought to occur because of a chromosome error in the embryo (either an extra or a missing chromosome) that occurs when the embryo is growing and dividing and is not related to any inherited genetic problem from the parents.
Although most miscarriages can’t be prevented, some factors are known to increase the risk, including:
- Maternal age of 35 or older
- Smoking, drinking alcohol or using recreational drugs
- Obesity
- Infections, such as certain sexually transmitted diseases, listeriosis (a type of food poisoning caused by Listeria bacteria) and other bacterial infections
- Preexisting health conditions, such as diabetes and thyroid problems
- Autoimmune disorders, such as lupus and antiphospholipid syndrome (also called APS)
- Hormone problems, such as polycystic ovary syndrome (also called PCOS) and luteal phase defect
- Uterine problems such as fibroids or scarring
- Cervical insufficiency (also called incompetent cervix), which occurs when the cervix dilates (opens) too early in the pregnancy
Stillbirth risk factors
Stillbirth is defined as the loss of a fetus after 20 weeks of pregnancy. Stillbirths are far less common than miscarriages, occurring in about 6 out of every 1000 pregnancies (or less than 1 percent).
There are a number of factors that can result in a stillbirth, including:
- Placental issues, such as placental abruption and placental insufficiency
- Preeclampsia (a serious blood pressure disorder)
- Clotting disorders like antiphospholipid syndrome
- Maternal medical conditions such as heart disease, lupus, diabetes, epilepsy or thyroid disease
- Smoking, drinking alcohol or using recreational drugs
- Genetic problems (About 25 percent of all stillbirths are caused by a birth defect.)
- Infections
- Umbilical cord issues
- Trauma
- Being pregnant with twins or multiples
Like miscarriages, stillbirths are often not preventable and may occur because the baby’s development is abnormal.
What are the chances of having a second miscarriage or stillbirth?
Causes of repeat miscarriages
About 1 in 100 women will experience a repeat miscarriage. For 50 to 75 percent of these women, the cause of their repeat miscarriage is unknown. The good news is that about 65 percent of women who experience a repeat miscarriage eventually go on to have a successful pregnancy.
If you have recurrent miscarriages, your doctor may recommend certain tests to try and determine an underlying cause. These might include:
- Blood tests to check your hormone levels and screen for autoimmune diseases like lupus and APS
- Chromosome tests to look for underlying genetic issues in the mother or father
- Ultrasounds to look for any abnormalities in the uterus
Causes of repeat stillbirths
Only about 1 to 2 percent of women who experience a stillbirth will go on to have another. If you experience a stillbirth, your doctor will recommend tests to look for an underlying cause. These might include:
- Examination of the umbilical cord and placenta, including genetic tests to check for Down’s syndrome
- Blood tests for issues such as preeclampsia, obstetric cholestasis, infection and thyroid problems
You can also choose to have an autopsy performed on your baby to determine their exact cause of death. Although an autopsy is optional, it can provide helpful information if you plan to become pregnant again in the future.
Learning that you have a blood disorder during pregnancy can be scary. Understand the common causes, complications and treatment options so you can have the healthiest possible pregnancy for you and your baby.
Is there a way to reduce my chances of having a repeat miscarriage or stillbirth?
Miscarriages and stillbirths are often not preventable. However, you can improve your chances of having a healthy baby by making healthy lifestyle choices both before and during pregnancy, as well as receiving careful monitoring and adequate prenatal care. This may include more frequent ultrasounds, blood tests and fetal heart rate monitoring.
Additional steps you can take to protect your baby’s health include:
- Notify your doctor right away if you experience any vaginal bleeding.
- Familiarize yourself with your baby’s movements and start performing regular “kick counts” around 26 weeks.
- Maintain a healthy weight.
- Avoid certain foods, such as raw or undercooked eggs, meat and fish, as well as unpasteurized dairy and soft cheeses.
- Protect yourself against infection.
- Limit caffeine intake.