3.2 million stillbirths: epidemiology and overview of the evidence review

Lawn, Joy E; Yakoob, Mohammad Yawar; Haws, Rachel A; Soomro, Tanya; Darmstadt, Gary L.; Bhutta, Zulfiqar Ahmed

doi:10.1186/1471-2393-9-s1-s2

Cited by 177 publications

(204 citation statements)

References 35 publications

(37 reference statements)

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“…99 Additionally, there are missed opportunities to include stillbirth outcomes in related studies. In an analysis of Cochrane reviews, 54 apart from trials on cervical cerclage, only a few pregnancy and intrapartum maternal intervention trials reported stillbirth or neonatal outcomes.…”

Section: Research Priorities For Stillbirth Epidemiologymentioning

confidence: 99%

“…25,54,55 Approaches vary, with some focusing on fetal causes (Wigglesworth), others on maternal causes (Aberdeen) or placental pathology, or a combination of both. 54,55 The most recent classifi cation systems have been devised for high-income countries and have complex categories requiring placental examination, advanced diagnostics, and post-mortem services. Some allow more than one cause per death, which is useful for programmes but not compatible with ICD rules.…”

Section: Why Do Stillbirths Occur?mentioning

confidence: 99%

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Stillbirths: Where? When? Why? How to make the data count?

et al. 2011

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for The Lancet's Stillbirths Series steering committee* Despite increasing attention and investment for maternal, neonatal, and child health, stillbirths remain invisible-not counted in the Millennium Development Goals, nor tracked by the UN, nor in the Global Burden of Disease metrics. At least 2·65 million stillbirths (uncertainty range 2·08 million to 3·79 million) were estimated worldwide in 2008 (≥1000 g birthweight or ≥28 weeks of gestation). 98% of stillbirths occur in low-income and middle-income countries, and numbers vary from 2·0 per 1000 total births in Finland to more than 40 per 1000 total births in Nigeria and Pakistan. Worldwide, 67% of stillbirths occur in rural families, 55% in rural sub-Saharan Africa and south Asia, where skilled birth attendance and caesarean sections are much lower than that for urban births. In total, an estimated 1·19 million (range 0·82 million to 1·97 million) intrapartum stillbirths occur yearly. Most intrapartum stillbirths are associated with obstetric emergencies, whereas antepartum stillbirths are associated with maternal infections and fetal growth restriction. National estimates of causes of stillbirths are scarce, and multiple (>35) classifi cation systems impede international comparison. Immediate data improvements are feasible through household surveys and facility audit, and improvements in vital registration, including specifi c perinatal certifi cates and revised International Classifi cation of Disease codes, are needed. A simple, programme-relevant stillbirth classifi cation that can be used with verbal autopsy would provide a basis for comparable national estimates. A new focus on all deaths around the time of birth is crucial to inform programmatic investment. Why don't stillbirths count?Stillbirths are invisible in many societies and on the worldwide policy agenda, but are very real to families who experience a death. Despite 30 years of attention to child survival interventions, 1,2 more than 20 years of attention to safe motherhood, 3,4 and increasing recent attention to survival of newborn babies, 5-7 the focus worldwide has remained on survival after livebirth. Stillbirths remain mostly ignored, not counting on policy, programme, and investment agendas, both internationally and often also at the national level. 8 The importance of neonatal deaths has risen on the worldwide policy agenda, mainly because of the Millennium Development Goals (MDGs) and recognition of the increasing proportion of child deaths that happen in the fi rst month of life-from 37% in 2000 7 to 41% in 2008. 9 A baby who dies just after birth counts in the MDG tracking, but a baby who dies in the third trimester or even during labour does not. Neither the MDGs nor the Global Burden of Disease metrics mention stillbirths, and stillbirth data are not routinely compiled by the UN. Even when stillbirths are recorded in surveys, the data are frequently combined with early neonatal deaths and reported as perinatal mortality, a combination that reduces visibility and might mask reporti...

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Section: Research Priorities For Stillbirth Epidemiologymentioning

confidence: 99%

Section: Why Do Stillbirths Occur?mentioning

confidence: 99%

Stillbirths: Where? When? Why? How to make the data count?

et al. 2011

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“…[2,3]Suboptimum care during pregnancy and labour results in macerated stillbirths and fresh stillbirths respectively. [4,5]Stillbirths during pregnancy are usually due to lack of adequate nutrition ,hypertensive disorders ante partum hemorrhage, genetic abnormalities in fetus, maternal infections and exposure to some toxic agents . [6]Intrapartum deaths are usually related to prolong and neglected labour ,malpresentations and cord related complications .Present study was carried out to find out the socio economic profile of women who had stillbirths after institutional delivery and different medical and obstetric causes related to these stillbirths.…”

Section: Introductionmentioning

confidence: 99%

Review of Socio Demographic Factors and Obstetric Causes of Stillbirths at Tertiary Care Hospital

B¹,

M²,

A³

2012

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Background: -Occurrence of stillbirth pose difficult situation for the obstetrician and cause great psychological and emotional trauma to the couple and the family. It reflects the suboptimum quality of maternal and child health services. Stillbirth rates are unacceptably high in developing countries .Study was carried out to find out the causes of stillbirths and the socio demographic profile of women ,who had stillbirth. Material and Methods: -A clinical observational study was undertaken at tertiary care teaching hospital over a period of 10 months from January 2011 to October 2011. Results:-Illiteracy, rural residence, lack of antenatal care ,low socioeconomic status were commonly associated with stillbirths. Pregnancy induced hypertension, ante partum hemorrhage ,cord related accidents and preterm labour were mainly responsible for stillbirths .Low birth weight and extreme prematurity were directly related to stillbirths. Conclusion:-High rate of ante partum stillbirths due to hypertension ,ante partum hemorrhage and preterm labour can be reduced by early recognition of the problem ,regular antenatal check ,color Doppler study to diagnose fetal growth restriction, and timely obstetric intervention .Ultrasonograpy to diagnose cord abnormalities ,use of intrapartum electronic fetal monitoring, partograph and prevention of prolongation of second stage of labour will help in reduction of stillbirths.

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“…It is thought that globally there are at least 3.2 million stillbirths per year [10]. Infections, problems related to the placenta and umbilical cord, congenital anomalies, maternal [11].…”

Section: Discussionmentioning

confidence: 99%

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

Drews¹,

Różycka²,

Barlik³

et al. 2017

Ginekol Pol

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Objectives: Choline and folate metabolism disturbances may be involved in the occurrence of intrauterine fetal death (IUFD). The proper activity of this metabolism could be determined by genetic variants involved in choline pathway e.g. CHKA (gene encoding choline kinase α), PCYT1A (gene encoding CCTα) and CHDH (gene encoding choline dehydrogenase). Our study aimed at determining the genotype and allele frequencies of CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms in mothers with IUFD occurrence. Material and methods:The study involved 76 mothers with IUFD occurrence and 215 mothers of healthy children. Genetic analysis was performed with the use of PCR/RFLP method. Results:The frequency of genotypes and alleles of studied polymorphisms was similar in both groups. The study revealed no association of PCYT1A, CHKA and CHDH polymorphisms in analysed groups of women. While evaluating the co-existence of analysed polymorphisms statistically significant correlation was revealed. Co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes was observed statistically more frequently in the study group than in the control group (p = 0,031). Conclusions:There is no correlation between single CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms and the incidence of intrauterine fetal death. However, revealed statistically significant difference between co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes between study groups suggest the need of further analysis.

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3.2 million stillbirths: epidemiology and overview of the evidence review

Cited by 177 publications

References 35 publications

Stillbirths: Where? When? Why? How to make the data count?

Stillbirths: Where? When? Why? How to make the data count?

Review of Socio Demographic Factors and Obstetric Causes of Stillbirths at Tertiary Care Hospital

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

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