Stillbirth affects approximately 1 in 175 births in the United States, totaling approximately 21,000 births each year [1]. Placental histopathology and fetal autopsy have the highest utility in identifying the cause of a stillbirth, and are recommended by the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) [2]. Information on pathology following stillbirth was added to the U.S. Fetal Death Data Files in 2014, collected from fetal death certificates nationwide. It was previously reported using those data files that the prevalence of fetal autopsy was 20.9% among stillbirths between 2014 and 2016 [3], with the prevalence of placental histopathology not reported.
Evidence on the use of fetal autopsy and placental histopathology following stillbirth in recent years and how utilization has potentially changed over time is needed and currently lacking. Despite the prevalence of stillbirth in the United States, the causes of death continue to be understudied, likely due in part to the barriers in the use of postmortem exams [4, 5]. Strengthening evidence on stillbirth pathology and its utilization is a critical step in the effort to improve stillbirth prevention and support families affected by stillbirth [2, 4, 5].