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Obesity, Disparities in Care Help Drive U.S. Stillbirths: Studies
Date:4/14/2011

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, April 13 (HealthDay News) -- While the rate of stillbirths in the United States has dropped over the past few decades, this tragic outcome is still a reality for far too many couples, experts say.

As part of a series of studies published online April 14 in The Lancet, researchers report that a leading cause of stillbirth in the United States may be obesity, which can raise the risk for fetal loss.

Obese women are more likely to have diabetes and hypertension, and "these are two of the major causes of stillbirth," noted the lead author of one paper, Dr. Robert L. Goldenberg, a professor of obstetrics and gynecology at Drexel University College of Medicine in Philadelphia. "But for reasons that are not clear, above diabetes, above hypertension, obese women are still more likely to have a stillbirth [than thinner women]."

Limits on women's access to good obstetric care -- most notably for poor or minority mothers-to-be -- is another major contributing factor. "My estimate is that if all women had access to very good care, a third to half of the stillbirths in the U.S. could be eliminated," Goldenberg said.

The definition of stillbirth varies country to country. In the United States, it's typically defined as fetal loss at 20 weeks or more of gestation, while the World Health Organization defines it as fetal death at 28 weeks or later.

Stillbirths are even more prevalent in less affluent countries. In fact, worldwide the problem accounts for more than 2.6 million fetal deaths each year. Ninety-eight percent occur in low-income countries, but wealthier countries, including the United States, also experience many stillbirths each year, researchers say.

"Stillbirth does not receive the focus it deserves, because it is a major pregnancy outcome that has been neglected," said Goldenberg. "In the United States there are about 27,000 stillbirths e
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