Evidence Matters

Can Daughters Inherit a Predisposition Towards Stillbirth from Their Mothers?

BACKGROUND AND PURPOSE:

Previous studies have suggested heritable predisposition, mother to daughter, may exist for certain pregnancy complications such as preeclampsia
It is unknown if risk of stillbirth is also heritable
Woolner et al. (AJOG, 2019) investigated whether there is a heritable predisposition to stillbirth from mother to daughter

Nested case-control study (1949–2016)
Participants
- Intergenerational cohort
- All mothers with at least 1 daughter
- Multiple pregnancies excluded due to inherent increased risk of stillbirth
- Mother-daughter pairs were linked with the use of the Scottish Community Health Index number
Exposure
- Mother’s history of stillbirth
- Mother’s history of miscarriage
Cases and controls:
- Cases: Daughters with a history of ≥1 stillbirth
- Controls: Daughters who delivered only liveborn infants
Primary outcome
- Stillbirth in any of the daughter’s pregnancies
Data Analysis
- Estimated odds ratio (OR) was calculated
- Multi-adjusted analyses were performed to include cofounders at the daughters’ pregnancy level

26,788 unique mother-daughter pairs were included
- Cases: 384 daughters had a history of ≥1 stillbirths
- Controls: 26,404 daughters only ever had livebirths
No statistically significant association between mothers’ history of stillbirth or miscarriage and stillbirth in daughters
- Mothers’ history of stillbirth: adjusted OR 0.63 (95% CI, 0.24–1.63)
- Mother’s history of miscarriage: adjusted OR 1.01 (95% CI, 0.71–1.42)

Nested case-control model used because stillbirth is such a rare outcome
This is the first large study to look at heritability of stillbirth
- Results consistent with previous research that did not find heritable predisposition of placental dysfunction
Results do not support a heritable predisposition for stillbirth between mother and daughter

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