Expiration Date: November 17, 2026
Notice Number: NOT-HD-23-021
Background
Stillbirths account for a large proportion of perinatal mortality. According to vital statistics, stillbirth affects one in 160 pregnancies, with 24,000 babies stillborn each year. More than 60% of stillbirth cases remain unexplained, with no known cause after the exclusion of common causes, such as obstetric complications, infections, placental insufficiency or abruption, umbilical cord complications, and congenital abnormalities with or without known genetic cause. People who have experienced stillbirth are almost five times as likely to experience another stillbirth or other pregnancy associated complication. Moreover, nearly 1 in 4 stillbirths could be preventable, and the rate of stillbirth is considerably higher among Black, American Indian, and Alaska Native people.
NICHD formed the Stillbirth Working Group of Council, a subgroup of NICHD’s National Advisory Child Health and Human Development Council, in response to a U.S. Department of Health and Human Services request to lead a Congressionally mandated task force to examine stillbirth in the U.S., with a focus on the following issues:
- Current barriers to collecting data on stillbirths in the United States
- Communities at higher risk for stillbirth
- Psychological impact and treatment for pregnant people and parents following stillbirth
- Known risk factors for stillbirth
Research Objectives
This NOSI is part of a multi-pronged approach in response to the Stillbirth Working Group’s recommendations. A wide variety of risk factors-including pregnancy complications, chronic health conditions, genetics, environmental factors, and social determinants of health-have been associated with stillbirth and other adverse pregnancy outcomes. However, known risk factors account for a limited proportion of the variation in stillbirth rates. More research is needed to discover additional risk factors and delineate the mechanisms of how these risk factors and their interaction lead to stillbirth.
Topics of interest for this NOSI include but are not limited to:
- Characterize risks for stillbirth, with an emphasis on parental contribution (other than genetic) from conception, fetal development, and their contributions to stillbirth
- Investigate the genetic contribution of parental, conceptus and fetal polymorphisms and de novo mutations in stillbirth.
- Investigate gene function involved in stillbirth to provide the causal link between possible genetic variants and patient phenotypes.
- Methodological research on improving accuracy of stillbirth data collection along with the accuracy of other data needed to identify disparities in stillbirth.
- Identify potentially modifiable environmental influences and their role in stillbirth.
- Identify social, behavioral, and structural factors that impact the likelihood of experiencing stillbirth.
- Interventions to address the impact of structural causes of stillbirth.
- Elucidate the racial, ethnic, and nativity disparities impacting stillbirth.
- Develop research capacity that serves specific contexts and communities with emphasis on highest burden settings.
- Conduct clinical trials that will lead to stillbirth risk reduction through known interventions.
- Conduct translational and implementation research to lead to a better understanding of effective interventions.
- Determine causes of and differential susceptibility to infection, and maternal-fetal immune responses associated with stillbirth, utilizing high dimensional systembiology approaches.
- Develop novel techniques, interventions, methodologies, and computational models that could aid in stratifying and targeting high-risk populations to substantially advance research and stillbirth prevention.
- Investigate tools to assess the support needed by birthing people and families after stillbirth due to pregnancy or childbirth complications.
- Investigate best practices in supporting health-care workers caring for people experiencing stillbirth.
- Develop non-invasive or minimally invasive autopsy techniques for detecting cause of death to increase autopsy uptake rates and contribute to the identification of cause of death to aid in the development of stillbirth prevention strategies.
- Develop predictive models to assess the likelihood of stillbirth integrating genetic, environmental, and medical status and history.
For more information, please see the opportunity webpage.