The loss of a child is the most painful situation that parents can experience. It is a truncated life, a baby that is expected and is not born, or dies shortly after birth. Understanding and supporting the couple is essential to help them overcome this difficult time.
Perinatal death is one that occurs, according to the WHO, from the 22nd week of gestation, during childbirth or during the first seven days of the newborn’s life. The United Nations places it at 28 weeks of gestation.
According to this organization, about two million babies are stillborn each year. In Spain, the perinatal mortality rate is between 4 and 5 babies per thousand births .
Perinatal death includes gestational or fetal death and neonatal death. Gestational death is one that occurs during pregnancy, when the fetus is more than 22 weeks. In the event that death occurs after 28 weeks and is even born but does not exceed the first week of life, it is called perinatal death .
When the baby is born, but complications occur and dies within 28 days of delivery, it is known as neonatal death.
Some classifications avoid weeks and speak of the baby’s weight, considering perinatal death to be that which occurs from 500g or more of fetal weight.
Depending on the time of death, perinatal mortality is divided into:
- Early or early death : between 20-26 weeks of gestation.
- Late fetal death : from 28 weeks of gestation until birth.
- Early Neonatal Death – During the first seven days after birth.
- Late Neonatal Death – Between the eighth and twenty-eighth day after the baby is born.
Associated risk factors
Why does the death of the baby occur during pregnancy, childbirth or shortly after birth? Can it be prevented? There are a number of factors that significantly increase the risk of perinatal death , such as:
- Mother’s age: both teenage pregnancy and late-life pregnancy.
- Lack of timely prenatal controls.
- Smoking, alcoholism and drug addiction.
- Prematurity and low birth weight.
- Maternal conditions: preeclampsia, anemia, uterine rupture, placental problems.
- Multiple pregnancy.
- Caesarean section.
It is also necessary to take into account social, biological or environmental factors that can influence, such as socioeconomic level or access to a good health system.
Causes of perinatal death
It is not always possible to know the reason for death, the causes are unknown in up to ten percent of cases and this can be even more traumatic for the parents.
Most of the time, death is caused by complications related to pregnancy and childbirth.
Most common causes of stillbirth in pregnancy and childbirth
- congenital anomalies
- serious malformations
- Medical complications of the mother: hypertension, preeclampsia, gestational diabetes, etc.
- intrauterine infections.
- Complications in the functioning of the placenta.
- Umbilical cord complications.
- Fetal growth restriction (when the fetus cannot reach its growth potential)
Most common causes of neonatal death (newborn)
According to the WHO, the most frequent causes of neonatal deaths are:
- Low birth weight and prematurity
- Congenital malformations and chromosomal abnormalities
- Disorders related to fetal growth
- Metabolic problems: deficiencies in essential products for brain metabolism (such as glucose) or insufficient minerals such as calcium, potassium, sodium, phosphorus, iron and magnesium. However, there are screening programs to detect these possible metabolic alterations, such as the heel prick test.
- birth trauma
- Complications of events during childbirth
- Respiratory and cardiovascular disorders