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Significant life events may be linked to stillbirths and racial disparities

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A recent study by Emory researchers and the National Institute of Child Health and Human Development links the stress of significant life events to the increase in stillbirths among all women. The study indicates that stillbirths—fetal deaths that occur at 20 weeks of gestation or greater--are now nearly equal in number to infant deaths in the US and twice as likely among African-American women. The complete study is featured in the April 2013 issue of the American Journal of Epidemiology.

Led by Carol J. Hogue, PhD, Terry Professor of Maternal and Child Health at Emory’s Rollins School of Public Health, the study measured the impact of 13 significant life events on women who experienced stillbirths and live births. Each event was categorized into four factors such as financial, traumatic, partner-related and emotional to determine its impact on pregnant women. The findings suggested that in the 12 months leading up to their delivery, one in five women reported at least one significant life event in three or all four of the factors. In African-American women, one in three reported at least one event in three or all four factors.

"After controlling for other conditions that could cause stillbirths, we found that experience of a stressful event in all four factors increased the risk of stillbirths by about two fold," explains Hogue. Also, there was an increased risk of stillbirths associated with an increasing number of events, suggesting a 'dose-response' effect of stress on stillbirth risk."

The investigators found that some of the excess stillbirth risk for African-American births could be attributed to the higher number of stressful events that African-American women had, on average.

Hogue and team studied approximately 600 stillbirths and 180 births, representing about 80,000 deliveries from 59 hospitals throughout the US. A total of four out of five women experienced at least one significant life event. The team recommends the need for implementing certain support programs into a woman’s prenatal treatment to help reduce the risk of stillbirths.

"Pregnant women are dealing with major issues along with their pregnancy," she says.  "In addition to their prenatal needs, the potential public health impact of effective interventions could be substantial and help increase the delivery of healthy babies."

A copy of the complete study is available online at

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