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A newly published large-scale study reveals that stillbirths in the United States occur more frequently than official estimates have indicated, affecting roughly one in every 150 pregnancies nationwide—significantly higher than the previously reported rate of one in 175. This comprehensive research highlights a troubling public health concern that disproportionately impacts low-income and racially marginalized communities and underscores urgent needs for enhanced preventive strategies.
Key Findings from the Study
The study, conducted by researchers at Harvard T.H. Chan School of Public Health and Mass General Brigham and published on October 27, 2025, in JAMA, analyzed data from more than 2.7 million pregnancies between 2016 and 2022. Using commercial insurance claims combined with demographic data from multiple sources—including the Health Care Cost Institute, American Community Survey, and March of Dimes—the researchers identified 18,893 cases of stillbirth.
Their analysis revealed an overall stillbirth rate of 1 in 150 births, exceeding the Centers for Disease Control and Prevention’s (CDC) prior estimate of 1 in 175 births. More alarmingly, stillbirths were concentrated in socioeconomically disadvantaged areas, with rates as high as one in 112 births in low-income regions. Racial disparities were pronounced as well; communities with higher proportions of Black families experienced stillbirths at twice the rate of predominantly White areas—approximately one in every 95 births.
The research also uncovered that nearly 30% of stillbirths occurred without identifiable clinical risk factors, especially in pregnancies reaching 40 weeks or beyond. Known maternal and fetal risks examined included obesity, hypertension, diabetes, substance use, history of adverse pregnancy outcomes, fetal growth restriction, and anomalies. However, the substantial fraction of unexplained stillbirths points toward gaps in current understanding and risk prediction methods.
Expert Perspectives and Context
Jessica Cohen, co-leader of the study and professor of health economics, emphasized, “Both data sources—the data in our study and the CDC’s—have potential shortcomings, but the critical concern remains that the stillbirth rate is unacceptably high.” She further noted that a significant proportion of stillbirths, especially those occurring late in pregnancy, may be preventable with improved predictive tools and interventions.
Dr. Lucky Jain, a noted maternal-fetal medicine expert who has co-chaired the Stillbirth Working Group for the National Institute of Child Health and Human Development, remarked, “Stillbirth remains a major public health challenge in the U.S., compounded by systemic issues including racial disparities and insufficient research.” He stressed the importance of quality data collection, research into causes, and improved clinical practice to reduce these losses.
Background and Public Health Implications
Stillbirth, defined as fetal death at 20 weeks of gestation or later, affects about 1 in 150 pregnancies in the U.S., translating into nearly 21,000 families experiencing this loss each year. Despite advances in prenatal care, the U.S. continues to have among the highest stillbirth rates of high-income countries, with little improvement over recent years.
Socioeconomic and racial disparities in stillbirth rates reflect broader social determinants of health, such as access to quality prenatal care, environmental exposures, stress, and systemic inequities. The study’s findings suggest that targeted public health programs addressing these determinants alongside clinical risk factors could improve pregnancy outcomes, especially in marginalized communities.
Potential Limitations and Balanced Considerations
While this study utilizes a large and rich dataset, it excludes births covered by Medicaid, the government insurance program for low-income individuals, where outcomes may be worse and disparities even more pronounced. Thus, actual national stillbirth rates could be higher than reported.
Additionally, precision limitations exist in administrative data, and the unknown causes of many stillbirths highlight the need for further research to uncover underlying mechanisms and enhance prevention. Experts recommend integrating improved screening, increased patient awareness, and standardized stillbirth investigations to address these gaps.
Implications for Readers’ Daily Health Decisions
For expectant parents and those planning pregnancies, these findings underscore the importance of regular prenatal visits and open communication with healthcare providers about any concerns. Monitoring fetal movement, managing chronic health conditions such as hypertension or diabetes, and avoiding tobacco or substance use are practical steps to reduce risk.
Healthcare providers are encouraged to consider socioeconomic contexts in prenatal care and advocate for equitable access to high-quality obstetric services to mitigate disparities. Public health initiatives focusing on social determinants and late-pregnancy monitoring may also help prevent some stillbirths.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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