Stillbirths: what difference can we make and at what cost?

Bhutta, Zulfiqar Ahmed; Yakoob, Mohammad Yawar; Lawn, Joy E; Rizvi, Arjumand; Friberg, Ingrid K.; Weissman, Eva; Buchmann, Eckhart; Goldenberg, Robert L.

doi:10.1016/s0140-6736(10)62269-6

Cited by 263 publications

(179 citation statements)

References 94 publications

(78 reference statements)

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“…19 After knowing the causes of death and associated causes of stillbirths in our study, it is evident that the above mentioned interventions are also required to be implemented judiciously to reduce the stillbirth.…”

Section: Causes Of Stillbirthsmentioning

confidence: 89%

Cause of death and associated conditions of stillbirths

Prasanna

Mahadevappa

Antaratani

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Section: Causes Of Stillbirthsmentioning

confidence: 89%

Cause of death and associated conditions of stillbirths

Prasanna

Mahadevappa

Antaratani

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…Impact analysis: The recent review from the Lancet Stillbirth series [228] reported that with each 1% increase in cesarean section births, intrapartum stillbirths decreased by 1Á61 per 1000 births. However, in a study by Lumbiganon et al [229], the risk of maternal mortality and morbidity index was increased for operative vaginal delivery (i.e.…”

Section: Lower-segment Cesarean Section (Lscs)mentioning

confidence: 99%

The interconnections between maternal and newborn health – evidence and implications for policy

Lassi

Majeed

Rashid

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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The past decade has witnessed increasing global attention and political support for maternal, newborn and child health. Despite this increased attention, actual progress has been slow and sporadic: coverage of key maternal and newborn health interventions remains low and there are wide disparities in access to care, within and across countries. Strategies for improving maternal and newborn health are closely linked, and can be delivered most effectively through a continuum of care approach. While these interventions are largely known, there is little information on which interventions have a positive health impact for both women and newborns. This supplement identifies the interventions during the preconception, pregnancy, intrapartum and postnatal periods found to have a positive, synergistic effect on maternal and neonatal outcomes. These interventions are then grouped into packages of care for delivery at the community, health center or hospital levels.

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“…Most intrapartum stillbirths occur because of poor‐quality care during childbirth; improvements in intrapartum care, closer fetal monitoring and access to operative delivery have dramatically reduced the number of such deaths 5, 6. However, the prevention of antepartum stillbirths has proved to be more challenging.…”

Section: Introductionmentioning

confidence: 99%

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

Hirst

Villar

Víctora

et al. 2016

BJOG

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ObjectivesTo identify risk factors for antepartum stillbirth, including fetal growth restriction, among women with well‐dated pregnancies and access to antenatal care.DesignPopulation‐based, prospective, observational study.SettingEight international urban populations.PopulationPregnant women and their babies enrolled in the Newborn Cross‐Sectional Study of the INTERGROWTH‐21st Project.MethodsCox proportional hazard models were used to compare risks among antepartum stillborn and liveborn babies.Main outcome measuresAntepartum stillbirth was defined as any fetal death after 16 weeks’ gestation before the onset of labour.ResultsOf 60 121 babies, 553 were stillborn (9.2 per 1000 births), of which 445 were antepartum deaths (7.4 per 1000 births). After adjustment for site, risk factors were low socio‐economic status, hazard ratio (HR): 1.6 (95% CI, 1.2–2.1); single marital status, HR 2.0 (95% CI, 1.4–2.8); age ≥40 years, HR 2.2 (95% CI, 1.4–3.7); essential hypertension, HR 4.0 (95% CI, 2.7–5.9); HIV/AIDS, HR 4.3 (95% CI, 2.0–9.1); pre‐eclampsia, HR 1.6 (95% CI, 1.1–3.8); multiple pregnancy, HR 3.3 (95% CI, 2.0–5.6); and antepartum haemorrhage, HR 3.3 (95% CI, 2.5–4.5). Birth weight <3rd centile was associated with antepartum stillbirth [HR, 4.6 (95% CI, 3.4–6.2)]. The greatest risk was seen in babies not suspected to have been growth restricted antenatally, with an HR of 5.0 (95% CI, 3.6–7.0). The population‐attributable risk of antepartum death associated with small‐for‐gestational‐age neonates diagnosed at birth was 11%.ConclusionsAntepartum stillbirth is a complex syndrome associated with several risk factors. Although small babies are at higher risk, current growth restriction detection strategies only modestly reduced the rate of stillbirth.Tweetable abstractInternational stillbirth study finds individual risks poor predictors of death but combinations promising.

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Stillbirths: what difference can we make and at what cost?

Cited by 263 publications

References 94 publications

Cause of death and associated conditions of stillbirths

Cause of death and associated conditions of stillbirths

The interconnections between maternal and newborn health – evidence and implications for policy

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

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Stillbirths: what difference can we make and at what cost?

Cited by 263 publications

References 94 publications

Cause of death and associated conditions of stillbirths

Cause of death and associated conditions of stillbirths

The interconnections between maternal and newborn health – evidence and implications for policy

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21st Project

Contact Info

Product

Resources

About

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project