2.3 Stillbirth and FGR (1/3) Copy

The association between FGR and stillbirth has been overlooked for a long time.

  • Older classification systems such as that by Wigglesworth used in many reports tended to categorise most stillbirths as ‘unexplained’ 13
  • Weight of stillbirths after delivery were assessed by pathologists using a standard which was derived from other stillbirths! 14
  • In contrast, when plotting stillbirth weights on a fetal weight standard such as that of Hadlock derived from normal, term deliveries, many stillbirth weights were  below the lower centile limit. 
  • An average 2 days are deducted from the gestational age of stillborn fetuses in the third trimester to adjust for the average ‘fetal death to delivery’ interval 14, 15.

Furthermore, as the scatterplot shows, many stillbirths are also relatively small, without being SGA, i.e. more likely to fall between 10th-50th than 50th-90th centile.


13. Maternal and Child Health Consortium, CESDI 8th annual report: Confidential Enquiry of Stillbirths and Deaths in Infancy, London 2001. 

14. Gardosi J, Mul T, Mongelli M, Fagan D. Analysis of birthweight and gestational age in antepartum stillbirths Br J Obstet Gynaecol. 1998 May;105(5):524-30 https://doi.org/10.1111/j.1471-0528.1998.tb10153.x

15. Gardosi J, Kady SM, McGeown P, Francis A, Tonks A. Classification of stillbirth by relevant condition at death (ReCoDe): population-based cohort study. BMJ 2005; 331:1113-7 https://doi.org/10.1136/bmj.38629.587639.7C