2.6 Million Stillbirths Globally Each Year, Over 7,000 Each Day, Many Of Them Needless-14/4/11

2.6 Million Stillbirths Globally Each Year, Over 7,000 Each Day, Many Of Them Needless

98% of the 2.6 million stillbirths that occur globally each year are in low-income and middle-income countries - even so, among wealthy nations the toll is still high, estimated to be at about 1 in every 320 births, according to an article among a Series published this week in Lancet. The Series covers stillbirth rates worldwide, and puts forwards some proposed key actions that should be in place by 2020 to reduce this devastating event.

The 2.6 million stillbirths refers specifically to the WHO (World Health Organization) definition - ones that occur after 28 weeks of pregnancy, or the last trimester. A stillbirth is when the fetus has died in the uterus and the mother delivers the remains, including a baby that is not alive.

In the majority of rich nations, a still birth occurs after the 22nd week of pregnancy. If this definition were used there would be 45% more stillbirths in the annual global count. In rich countries, 1 in 200 births are stillborn from the 22nd week of pregnancy onwards, compared to 1 in 320 if they occur after 28 weeks.

Joy Lawn and team discuss the implications of the nationally reviewed stillbirth estimates WHO undertook. Rates worldwide vary considerably, from 1 in 500 in Finland to over 1 in 25 births in Nigeria or Pakistan. Over three-quarters of all stillbirths occurred in sub-Saharan Africa and south Asia, the authors report. Only 2% of stillbirths occur in developed nations. The majority of rich nations have fewer than 5 still births per 1,000 births. If developed nation stillbirth rates occurred globally, millions more babies would be born alive.

About 1.4 million stillbirths occur antepartum (before birth) while 1.2 million occur intrapartum (during birth). The majority of stillbirths that occur during birth are the result of childbirth complications, also known as obstetric emergencies, which have been mostly eliminated in wealthy nations.

Most stillbirths that occur antepartum are generally linked to maternal infections and fetal growth problems. Syphilis, for example, is a major preventable cause of stillbirth, which is fairly common in some nations. The biggest risk factors in rich countries are maternal age, smoking, and/or obesity.

In 1995 there were 3.03 million still births worldwide, compared to 2.64 million in 2009 - an overall drop from 22 per 1,000 to 19 per 1,000. While child-under-5 mortality fell 2.5% annually from 1995 to 2009, the stillbirth rate only dropped by 1.1% each year during the same period. Maternal mortality dropped by an average 2.5% per year.

Colombia, China and Mexico have had the largest falls in stillbirth rates from 1995 to 2009.

Black women in the UK and USA, and Indigenous females in Canada and Australia have double the risk of stillbirth compared to Caucasian women.

It is a myth to believe that stillbirth is an unfortunate, inevitable loss that cannot be prevented. Only 1 in every 20 stillbirths are linked to any congenital abnormality. Many do not realize or acknowledge that the risk of stillbirth is 3 times greater at 40 weeks of pregnancy than earlier on.