Risks of stillbirth and neonatal death with advancing gestation at term

Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies.
Javaid Muglu et al. PLOS Medicine.

This week sees the publication of a hugely important paper looking at the risk of stillbirth and neonatal death at different gestational ages.

In this study data from different papers were pooled in order to produce a study of 15 million pregnancies.

Stillbirth rates (the black line) were seen to increase with gestational age beyond 37 weeks but neonatal deaths (the red line) did not reduce from 37 weeks onwards.

It would therefore seem that waiting beyond 38-39 weeks for labour to start naturally may increase the risk of stillbirth without any benefit to the survival of the baby.

If pregnancy is prolonged past 40 weeks to 41 weeks then one additional baby will die for every 1449 pregnancies. Beyond this this gestation the stillbirth rates rise even more steeply. Women need to be made aware of this new statistic when they are considering the best time to have their baby.