What is the term for a stillborn fetus or one dying within 7 days of delivery, also known as early neonatal death (END)?

From the Guidelines

A stillborn fetus or one dying within 7 days of delivery is defined as early neonatal death (END) or perinatal mortality, which includes stillbirths and deaths within the first 7 days after birth. This definition is based on the most recent and highest quality study, which provides standardized definitions for the core outcome set for infertility 1. According to this study, stillbirth is defined as the death of a fetus prior to the complete expulsion or extraction from its mother after 20 completed weeks of gestational age, and early neonatal mortality is defined as death of a live born baby within 7 days of birth.

Key Definitions

• Stillbirth: death of a fetus prior to the complete expulsion or extraction from its mother after 20 completed weeks of gestational age 1
• Early neonatal mortality: death of a live born baby within 7 days of birth 1
• Perinatal mortality: encompasses both stillbirths and early neonatal deaths

Clinical Implications

When a stillbirth or early neonatal death occurs, immediate medical attention is necessary, and the mother should be hospitalized for delivery if stillbirth is diagnosed or for appropriate postpartum care if the infant dies after birth. Standard postpartum care includes:

• Monitoring for hemorrhage, infection, and ensuring uterine involution
• Pain management with ibuprofen 600mg every 6 hours or acetaminophen 650mg every 4-6 hours as needed
• Psychological support, including grief counseling and possibly referral to mental health professionals
• Follow-up care should include a postpartum visit within 1-2 weeks, pathological examination of the placenta, and potentially genetic testing or autopsy if consented to determine the cause of death 1.

From the Research

Definition of Stillbirth and Early Neonatal Death

• Stillbirth is generally defined as a death prior to birth at or after 22 weeks' gestation 2
• Early neonatal death (END) refers to a death within 7 days of delivery, which can be considered a stillbirth if it occurs before birth or a neonatal death if it occurs after birth

Classification of Stillbirth and Neonatal Death

• Stillbirth and neonatal death are often classified together as perinatal death, which includes deaths occurring from 22 weeks' gestation to 7 days after birth 2
• The term "stillbirth" is often used to describe a fetus that has died in the womb, while "neonatal death" refers to a death that occurs after birth, within the first 28 days of life 3, 4

Risk Factors and Causes of Stillbirth

• Stillbirth can occur due to various risk factors, including non-Hispanic black race, nulliparity, advanced maternal age, obesity, preexisting diabetes, chronic hypertension, smoking, and alcohol use 3, 4
• The exact cause of stillbirth may be difficult to determine, and a significant proportion of stillbirths remain unexplained even after a thorough evaluation 3, 4

Support and Care for Parents Experiencing Stillbirth or Neonatal Death

• Parents experiencing stillbirth or neonatal death require emotional support and clear communication of test results 5, 3, 4
• Referral to a bereavement counselor, peer support group, or mental health professional may be advisable for management of grief and depression 5, 3, 4