Researchers May Have Discovered What Causes Stillbirth — and How to Prevent It

Pregnant woman looking at her belly
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The loss of a baby during pregnancy or birth is a trauma that no parent should ever have to experience. And yet, stillbirth — defined as a pregnancy loss after the 20th week — is more common than you might think. According to the March of Dimes, stillbirth affects 23,600 babies per year, or 1 in 160 pregnancies.

Although doctors have come up with risk factors for stillbirth including genetic conditions or birth defects in babies and various health issues in the mother, there is no broad consensus about what causes it — or how it can be prevented. Many parents are told that “unknown factors” caused the loss of their baby. Not having answers at a time of such tremendous pain can be as traumatizing as the loss itself.

But one groundbreaking bit of research out of Australia may have the potential to change all that. Researchers at Hunter Medical Research Institute (HMRI) in Australia have found that the cause of many stillbirths is actually a deteriorating placenta, and developing tests to detect this condition early on may be the key to saving these babies.

“It certainly is the most exciting project I’ve been involved in so far, with the potential to influence people’s lives around the planet,” Dr. Roger Smith, one of the researchers, tells the Australian Broadcasting Corporation (ABC).

Dr. Smith says that it has to do with the aging of the placenta. Apparently in certain rare cases, the placenta can age prematurely — slowly cutting off nutrients and oxygen to a gestating baby, resulting in devastating loss.

“As you look around at everybody you know, you’ll notice that different people age at different rates,” explains Dr. Smith. “And it’s almost certainly the same with the placenta. Some placentas age more rapidly than others. If the placenta is not working, the levels of oxygen fall in the baby, and if they get low enough, the baby will die.”

So how might researchers like Dr. Smith detect these tragic changes in the placenta? It all comes down to the enzyme aldehyde oxidase, which is emitted by organs as they age. The researchers’ plan is to develop a test that would detect elevated levels of aldehyde oxidase in a mother’s bloodstream. If it is determined that the placenta is rapidly aging and the baby isn’t getting enough nutrients and oxygen, then the baby would be delivered early.

“It’s possible that we’ll be able to develop diagnostic tests to pick up in the mother’s blood the signs of ageing of the placenta, and therefore predict this devastating event, so that the obstetricians can perform a caesarean section and get the baby out before the baby dies,” said Dr. Smith. He goes on to say that the hope is to develop this test in the next 3 to 5 years.

Of course, early delivery would be a problem for certain babies — especially ones who need to be delivered before 27 weeks, when chances of survival are low.

But Dr. Smith and his team have a potential solution to that problem, as well:

“If a baby is too early in pregnancy to be delivered, we may be able to give drugs that inhibit that enzyme to slow the ageing of the placenta, and allow the baby to stay in the uterus until it is likely to survive when it’s born.”

Pretty incredible, huh?

Interestingly, aldehyde oxidase is an enzyme produced by all organs as they age. If scientists were able to inhibit it, the benefits to human life could be endless.

“It’s possible that if we develop different ways of stopping this enzyme working to cause damage, it may lead to lower levels of aging in other tissues and perhaps even healthy life extension,” he explains.

For now, Dr. Smith is focusing at what he considers the most important task at hand: preventing stillbirth. And he has a very important, heartfelt message for any parent out there who has experienced such an earth-shattering loss: It’s not your fault.

“I think it’s really important for mums of stillborn babies to understand that it’s not their fault,” he shares. “This is something that’s happened to the placenta; they had very little or no control over it. There was nothing they could do to prevent it. So they shouldn’t feel guilt about it.”

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