"Are we simply not providing good care during labor to African-American women? I really don't think that's true," Iams said. "What's happening is that more African-American women are coming into the hospital in labor at 21, 22 or 23 weeks, and the babies don't have much of a chance to survive. The higher stillbirth rate is the result of a much higher rate of premature birth."
Each year in the United States, about 26,000 pregnancies end in stillbirth. Globally, there are 3 to 4 million, Silver said.
Despite major advances over the last 30 years in reducing the number of premature babies that survive, stillbirth rates have remained stubbornly high.
"It's a major public health problem, but people haven't put the same clinical or research energy into reducing stillbirth as they have infant death," Silver said. "When a baby is born prematurely, they do better than they did 20 years ago, but we haven't made the same advances in stillbirth."
Iams, who wrote an accompanying journal editorial, said it's about time that changed. Instead of considering stillbirth as a separate problem from premature birth, researchers and physicians are now better understanding that the causes of pregnancy loss starting at about 16 weeks -- such a problems with the placenta and umbilical cord -- are many of the same causes that also lead to babies being born prematurely and stillbirth.
That may include doing away with drawing the line for stillbirth at 20 weeks, Iams added.
"Stillbirth has been considered by itself, and because it's been considered separately, it hasn't been linked to more well-known conditions, such as premature birth," Iams said. "It's often treated as something that is not going to happen again, or a random event. What these researchers have shown is that if you look hard enough, m
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