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Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies

PLoS Medicine Jul 08, 2019

Muglu J, et al. - Searching the major electronic databases Medline, Embase, and Google Scholar (January 1990–October 2018) without language restrictions, researchers conducted a systematic review including thirteen studies involving 15 million pregnancies, 17,830 stillbirths, for determining the risks of stillbirth and neonatal death at term (from 37 weeks gestation) according to gestational age. Four studies provided evidence that mothers of White and Black race are at risks of stillbirth, 2 studies suggested the risks in mothers of White and Asian race, 5 studies suggested the risks in mothers of White race only, and 2 studies suggested the risks in mothers of Black race only. They noted an increase in the prospective risk of stillbirth with gestational age from 0.11 per 1,000 pregnancies at 37 weeks to 3.18 per 1,000 at 42 weeks. An increase in neonatal mortality was observed when pregnancies continued beyond 41 weeks; for every 1,449 pregnancies that advanced from 40 to 41 weeks, one additional stillbirth occurred. These findings suggest that when term pregnancies continue to 41 weeks, risk of stillbirth increase significantly, with no corresponding reduction in neonatal mortality, compared to delivery at 40 weeks.
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