Stillbirth is the most devastating thing that can happen to an expectant mother, and often there is no explanation for why it happens. But scientists might be closer to finding out the reason some women are more at risk than others. A new study published in the American Journal of Obstetrics and Gynecology found the risk of stillbirth has to do with certain markers in the placenta that indicate it may no longer be working properly.
Placental aging could be the key
Australian researchers compared the chemistry of placentas from women who delivered at term (37 to 39 weeks), late term, and with unexplained stillbirth. "Our study showed that at the end of pregnancy, 40 to 41 weeks, many, but not all placentas are showing biochemical signs of aging," lead researcher Laureate Professor Roger Smith of the University of Newcastle in Australia tells Parents.com. The aging changes are damage to the fats, also called lipids, DNA, and another molecule called RNA. "The damage is caused by too much of an enzyme called aldehyde oxidase," he says. "The placentas from stillbirths showed exactly the same aging-related changes."
When it happens before term, this premature placental aging could be the reason why some babies don't survive. "Very little was known about the role of aging of the placenta in stillbirth before our study, which is why it is so exciting," Professor Smith says. But what's still unknown is exactly why some women's placentas start aging too soon. "The premature aging in these cases may be due to genetic factors, smoking, or other factors that are causing stress to the placenta," he says.
Whatever the reason the premature aging happens, this new research could mean that if women were screened for the excess enzyme, aldehyde oxidase, doctors might be able to pinpoint those at risk. "We are developing blood tests to predict which women are at risk of stillbirth to allow delivery prior to fetal death," Professor Smith says. "If the pregnancy is too early to allow delivery, then it may be possible to treat the woman with drugs that inhibit the enzyme that is causing the placental damage."
These tests are still in the future, so what can you do now to prevent your risk of stillbirth? "Of course pregnant women should not smoke," Professor Smith says. According to the March of Dimes, other factors that can increase your chances are being obese, having multiples, being over 35, having diabetes or high (or low) blood pressure, and complications during the current or a prior pregnancy. African-American women are also at greater risk, although doctors don't know why that is. Many of these factors are out of your control, so the best thing you can do is get proper prenatal care and avoid drugs and alcohol.
For many women who've suffered a stillbirth, answers remain elusive. "Firstly, women who have experienced a stillbirth should not blame themselves," Professor Smith says. "The placenta is an organ of the baby, not the mother, and regulating the aging of the placenta is beyond the control of the mother." Hopefully with his research, prevention and treatment may be on the horizon.