The National Institute of Child Health and Human Development (NICHD), one of the National Institutes of Health has begun a concerted effort to determine the extent and causes of stillbirth -- the death of a foetus at 20 or more weeks of pregnancy. Each year, more than 26,000 American women are reported to experience a stillbirth.

To date, it has been difficult to collect information on stillbirths because the criteria for reporting them vary from state to state, and the issuance of foetal death certificates is not required.

The NICHD awarded nearly $3 million to fund a national research effort to study stillbirth in the United States. The award will fund the Stillbirth Research Collaborative Network, consisting of five research centers around the country and an independent data center to collect and analyze statistics on stillbirth. The research and statistical centers will collaborate with the NICHD to design studies to determine the causes of stillbirth. The five-year effort will also seek to develop standardized research guidelines for reporting and investigating stillbirths.

The number of reported deaths from stillbirth is equal to that of all infant deaths combined. Some causes of stillbirth are known, such as diabetes or high blood pressure affecting the mother. However, the cause of more than half of all stillbirths is unknown.

"Stillbirth is a problem that affects families everywhere, but little is known about why it happens," said Duane Alexander, MD, director of NICHD. "A better understanding of stillbirth may lead to ways to prevent these deaths."

The five sites in the Stillbirth Research Collaborative Network will work with local hospitals to track stillbirths for the study. A variety of specialists, from obstetricians to grief counselors, will participate in the research initiative to support the mothers and their families, and to develop guidelines for studying and reporting stillbirths.

"Parents who suffer the loss of a fetus are often desperate for information about the cause," said Catherine Spong, MD, chief of NICHD's pregnancy and perinatology branch. "We hope this research will give us better information about stillbirth and its causes."

The Stillbirth Research Collaborative Network grew out of the March 2001 NICHD workshop, setting a research agenda for stillbirth, which brought experts from the US and several other countries together to address the serious, but under-studied, problem of stillbirth.

The Stillbirth Research Collaborative Network includes the following clinical investigators and research sites: Dr. Marshall Carpenter, Women and Infants Hospital of Rhode Island in Providence; Dr. Donald Dudley, University of Texas Health Sciences Center in San Antonio; Dr. George Saade, University of Texas Medical Branch at Galveston; Dr. Robert Silver, University of Utah in Salt Lake City; Dr. Barbara Stoll, Emory University in Atlanta, and Dr. Corette Parker, at the statistical center at Research Triangle Institute in Raleigh, North Carolina.