Stillbirths in the United States occur at a higher rate than previously reported, according to a groundbreaking study by researchers at the Harvard T.H. Chan School of Public Health and Mass General Brigham. The study, which is set to be published in the Journal of the American Medical Association (JAMA) on October 27, 2025, reveals that nearly 21,000 families are impacted by stillbirths annually, with a significant portion being potentially preventable.
Jessica Cohen, a professor of health economics and co-senior author of the study, emphasized the urgency of the findings.
“Our study highlights the pressing need to improve stillbirth risk prediction and prevention,”
she stated. The research underscores the need for more comprehensive investigations into the factors contributing to stillbirths, particularly those occurring at 40 weeks or later.
Comprehensive Analysis of Pregnancy Data
The study is one of the largest of its kind, analyzing over 2.7 million pregnancies across the U.S. from 2016 to 2022. Using data from commercial health insurance claims, the Health Care Cost Institute, the American Community Survey, and the March of Dimes, the researchers identified 18,893 stillbirths. They examined the relationships between these stillbirths and a range of clinical, fetal, obstetric, and socioeconomic factors.
Among the key findings, the study reports a stillbirth rate of more than 1 in 150 births, which is higher than the 1 in 175 births previously published by the Centers for Disease Control and Prevention. Notably, the rate was even higher in low-income areas, where 1 in every 112 births resulted in stillbirth. The disparity was also evident among racial lines, with areas having higher proportions of Black families experiencing a stillbirth rate of 1 in every 95 births.
Identifying Risk Factors and Gaps
The researchers found that while 72.3% of stillbirths had at least one clinical risk factor, a significant 27.7% occurred without any identified risk factors. This was particularly pronounced at later gestational ages: 24.1% of stillbirths at 38 weeks, 34.2% at 39 weeks, and 40.7% at 40+ weeks had no identified clinical risk factors. Conditions such as low amniotic fluid levels, fetal anomalies, and chronic hypertension were associated with the highest stillbirth rates.
Mark Clapp, co-senior author and a maternal-fetal medicine provider at Massachusetts General Hospital, commented on the study’s implications.
“Although momentum toward improving stillbirth research and prevention efforts has increased in recent years, rates in the U.S. remain much higher than in peer countries,”
he noted. Clapp expressed hope that the study would drive policy changes and further research to prevent such outcomes.
Socioeconomic Disparities and Future Directions
The study also highlights the need to explore the socioeconomic disparities in stillbirth rates. The researchers suggest that these variances may be influenced by social, health system, or clinical factors. Haley Sullivan, the study’s first author and a student in the Harvard PhD Program in Health Policy, along with co-author Anna Sinaiko from Harvard Chan, call for targeted research to understand these disparities better.
As the study garners attention, it underscores the critical need for enhanced data collection and analysis to inform public health strategies. The findings could pave the way for improved healthcare policies and practices aimed at reducing stillbirth rates across the United States.
Moving forward, the research community is urged to prioritize stillbirth prevention and address the gaps identified by this comprehensive study. The hope is to ensure that no family has to endure the tragedy of a preventable stillbirth, aligning U.S. rates more closely with those of other developed nations.
