Stillbirth (fetal death at 20 or more weeks gestation) is a major cause of perinatal loss, with long-term impacts on families and public health.1 While certain risk factors are well-documented, less is known about whether they are specific to early, late, or term stillbirth. We aimed to further understand timing-specific patterns, highlighting opportunities for targeted prevention.
We studied 246,775 pregnancies that occurred between January 1, 2017, and May 1, 2025, including those that had a miscarriage and those that did not, and matched pregnancies based on maternal age, gravidity, prior neonatal or fetal demise, and whether the pregnancy had more than one fetus. We accounted for demographics, BMI, smoking, rurality, census region, residence in a socially vulnerable area, multiple gestation status, maternal conditions, obstetric history, and prenatal care timing. Stillbirths were classified as early (20 to 27 weeks), late (28 to 36 weeks), or term (≥37 weeks).
Mothers who are Black experience markedly higher likelihood of stillbirths at each stage of stillbirth—up to 87% more likely compared to those who are White—as seen in Figure 1. A 9% increase in early pregnancy stillbirth was observed for Hispanic mothers. For other non-White mothers, representation was too low to establish statistical significance.
Mothers living in more rural areas are up to 35% more likely to experience a stillbirth compared to those living in more urban areas, as seen in Figure 2.
We evaluated 20 maternal conditions that could potentially influence the risk of stillbirth. Figure 3 shows those with the strongest correlation. Patients with diabetes consistently had increased likelihood of stillbirth across all stages. Mothers who had thrombophilia, severe obesity, hypertension, or chronic kidney disease (CKD), on the other hand, had varying relationships with the likelihood of stillbirth at different stages. For the results of all studied factors, see the tables in the PDF version of the brief.
