There is little information available for stillbirths, and no systematic national estimates have previously been published. Dr Joy Lawn (Saving Newborn Lives Initiative, Cape Town, South Africa), Dr Cindy Stanton (John Hopkins University, Baltimore, Maryland USA), and colleagues assessed data from 103 countries, and after using statistical models to correct for under-reporting, conclude that there were an estimated 3.2million stillbirths worldwide each year (with an uncertainty range of 2.5 to 4.1 million).
Data from three sources were used – countries with available vital registration data, demographic and health surveys, and finally data from studies identified through a systematic review. The final data consisted of 323 observations from 103 countries, and all world regions were presented. Under-reporting of stillbirths is a major problem. The countries with the highest risk of stillbirth have the least data that is useable and recent.
Stillbirth rates range from five per 1000 total births in rich countries, to 32 per 1000 total births in south Asia and sub-Saharan Africa. Low income countries such as Egypt have credible evidence of a decline in stillbirth rates, closely linked to the decline in maternal mortality.
The authors conclude: "Our estimates suggest that 3.2 million babies are born dead every year, and the true figure is probably higher given the limitations of the available data and the fact that stillbirths are under-reported. Better counting is not just for better epidemiology. The deaths of most of these babies are avoidable… In the 21st century we invest in detailing the human genome, but cannot even approximately count this huge number of dead babies. We are left to wonder if stillbirths count".
Dr Joy Lawn, Saving Newborn Lives Initiative, 11 South Way, Pinelands, Cape Town 7405, South Africa. T) +27 21 532 3494 / +44 7989528724 (UK mobile) E) firstname.lastname@example.org
From May 8: Save the Children/USA, Suite 500, 200 M Street, Washington DC, 20036, USA. T) +01 202 293 4170
Dr Cindy Stanton, John Hopkins University, Baltimore, Maryland USA. T) +01 301 741 5871
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