The SCRN was established in 2003 to examine the etiology and epidemiology of stillbirth, which is defined as fetal death at 20 weeks or more of gestation. In the United States, stillbirth occurs in approximately one out of every 200 pregnancies, or about 26,000 stillbirths per year, although the number has declined in the past decade. Not all cases of stillbirth are reported, and some studies suggest the actual number of stillbirths is significantly greater than the estimates. The cause or causes of about one-half of stillbirths are undetermined.
The Network, funded through the NICHD Pregnancy and Perinatology Branch (PPB), seeks to understand the causes of stillbirth, improve stillbirth reporting, and develop preventive interventions for the condition. In addition, the work of the SCRN is leading to the standardization of reporting procedures and post-mortem examination protocols, which allow more accurate data on the topic.
The SCRN is funded through a Cooperative Clinical Research Award mechanism (U10). The Network currently includes five clinical research sites at universities across the nation, as well as the Data Coordinating Center (DCC).
SCRN studies include surveillance, case-control, and follow-up studies on stillbirth. Case-by-case analyses include clinical history, postmortem examination of the fetus, and placental pathology. Network studies seek to identify risk factors for stillbirth, including environmental and geographical factors. Enrollment of 668 stillbirths and 1768 live births in 59 hospitals was completed August 31, 2008, and analysis is ongoing.
Current Network studies include (but are not limited to) the following:
- A surveillance study of all stillbirths occurring in the geographical catchment areas of the five clinical sites, involving retrospective record abstraction and prospective surveillance to assess the completeness of two sources of stillbirth reports, including (1) hospital labor and delivery logs and (2) state vital statistics records.
- A case-control study, which is the first large stillbirth study in the U.S. to simultaneously include population-based controls and complete fetal autopsy and placental pathology examinations, in order to obtain high quality information about stillbirth pregnancies, as well as study risk factors for stillbirth by obtaining detailed information from live birth controls.
- A follow-up study to determine the number of women who have had subsequent pregnancies and/or complications following a stillbirth; evaluate how well women who have had a stillbirth are able to resolve their grief; and examine whether lifecourse stresses and environmental factors are associated with an increased risk of stillbirth.
- Brown University
- Emory University
- University of Texas Medical Branch at Galveston
- University of Texas Health Science Center at San Antonio
- University of Utah
RTI International is the DCC for the SCRN.