Key Points
The most common causes of neonatal death are preterm birth, low birthweight and birth defects.
An autopsy may help you find out why your baby died. You can choose whether to have an autopsy done.
Your health care provider or a genetic counselor may help you learn why your baby died and whether there’s a risk of the same problems in another pregnancy.
Getting counseling and support can help you cope with your baby’s death.
What is neonatal death?
Neonatal death is defined as the death of a baby in the first 28 days of life. It happens in about 3.58 in every 1,000 births (less than 1 percent) each year in the United States. Your baby’s health care provider can help you learn as much as possible about why this happened.
What are common causes of neonatal death?
The most common causes of neonatal death are:
- Asphyxia. This is when a baby doesn’t get enough oxygen before or during birth.
- Birth defects.
- Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
- Preterm birth.
- Infections. Examples include sepsis (a blood infection), meningitis (an infection of the brain and spinal cord) or pneumonia (an infection of the lungs).
- Intraventricular hemorrhage. This is bleeding in the brain. Most brain bleeds are mild and resolve themselves with no or few lasting problems. More severe bleeds can cause serious problems for a baby.
- Necrotizing enterocolitis. This is a problem with a baby’s intestines. It can cause feeding problems, a swollen belly and diarrhea.
- Respiratory distress syndrome. This lung problem occurs most commonly in babies who are born before 34 weeks of pregnancy. Babies who have respiratory distress syndrome don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing.
If preterm birth is anticipated, your provider may offer medication to help your baby’s lungs develop quicker, protect the brain from hemorrhage and prevent the necrotizing enterocolitis.
Some pregnancy complications may cause a neonatal death:
- Preeclampsia.
- Problems with the placenta, umbilical cord and amniotic sac. If the membranes of the amniotic sac rupture and fluid is lost too early, the baby may deliver preterm or become infected and not survive.
What birth defects can cause neonatal death?
The most common birth defects that cause neonatal death include:
- Heart defects. Some babies who have serious heart defects may not survive long enough to have treatment, or they may not survive after treatment.
- Lung defects. A baby may be born with problems in one or both lungs or may have lungs that aren’t fully developed.
- Genetic conditions.
- Neural tube defects. If you’ve had a baby who had anencephaly, talk with your health care provider about taking folic acid to help prevent neural tube defects in your next pregnancy.
Prenatal Testing: These tests can identify problems that exist before birth and can help pregnant people prepare.
Your health care provider can use prenatal tests to check your baby for birth defects before birth. Although these tests don’t prevent the condition, they do help pregnant people identify if there will be a problem with the baby. These tests include:
- Amniocentesis at about 15-17 weeks to check the amniotic fluid for genetic changes
- Chorionic villus sampling at about 11-12 weeks to sample the area that the embryo implants
- Ultrasound at 9-11 weeks to check neck thickness
- Ultrasound at 19-22 weeks to check that the baby’s anatomy is normal
- Genetic Counseling to discuss family history and get information on testing available
- Blood Testing:
- Hemoglobin Electrophoresis to check blood for sickle cell and thalassemia
- Cystic Fibrosis screen
- QUAD screen at 15-19 weeks to identify birth defects
- NIPPS screen: newer testing with multiple genetic information
Is an autopsy required?
Your baby’s health care providers can tell you what might have caused your baby to die. If you want more information, you may ask for a medical examiner to do an autopsy. Not all autopsies provide enough information for doctors to understand what caused death. It’s your choice whether to have an autopsy performed.
If you don’t want an autopsy to be done, your baby’s health care provider may be able to use other tests to find more information about why your baby died. These tests include genetic tests, X-rays and tests on the placenta and umbilical cord.
If the cause of your baby’s death was a birth defect, you can meet with a genetic counselor to learn more about it. You also can learn about the chances of having another baby who has the same birth defect.
How can you deal with your grief?
Talking about your feelings may help you deal with the grief you feel about your baby’s death. Your health care provider, nurse and social worker can be a source of comfort and support during this time. It is important to take the time to grieve your lost baby and to seek help from your partner, family, friends and professional therapists if needed.
More information
- From Hurt to Healing (free booklet from the March of Dimes for grieving parents)
- Share Your Story (March of Dimes online community for families to share experiences with prematurity, birth defects and loss)
- Centering Corporation (general grief information and resources)
- Compassionate Friends (resources for families after the death of a child)
- First Candle (resources for families after the death of a child by SIDS or preventable stillbirth)
- Now I Lay Me Down to Sleep (remembrance photography)
- Perinatal Hospice & Palliative Care (resources for parents who find out during pregnancy that their baby has a life-limiting condition
- Share Pregnancy & Infant Loss Support (resources for families with pregnancy or infant loss)
Last reviewed: October 2024