Stillbirth Remains an 'Unacknowledged Problem'

These early deaths are rarely included in national medical records, study says

By Robert Preidt

Tuesday, May 20, 2014

Related MedlinePlus Pages

TUESDAY, May 20, 2014 (HealthDay News) -- Stillbirths are a largely "invisible" but major cause of death worldwide, according to a new study.

"In most countries stillbirths do not get birth or death certificates, which contributes to their invisibility; hence, most of the world's newborn deaths and almost all stillbirths enter and leave the world without a piece of paper to record their existence," said study leader Joy Lawn, a professor at the London School of Hygiene & Tropical Medicine.

The researchers analyzed data from 195 countries and found nearly 8,000 newborn deaths and about 7,000 stillbirths occur daily worldwide. That equates to 2.9 million newborn deaths and 2.6 million stillbirths a year.

The United Nations tracks newborn deaths, but not stillbirths, even though they share many of the same causes, the researchers said. Stillbirth, which is when a woman loses her baby during the last three months of pregnancy, happens after a full nine months of pregnancy in about half of all cases.

The findings suggest that stillbirth is an important, but largely unacknowledged problem worldwide, said the authors of the study published May 20 in The Lancet.

"The fact that the vast majority of these deaths -- which have a huge effect on the women and families involved -- are never formally included in a country's health registration systems signifies acceptance that these deaths are inevitable, and ultimately links to inaction," Lawn added in a journal news release.

Worldwide rates of newborn deaths declined by an average of 2 percent between 1990 and 2012, but declines in death rates were higher among children older than 1 year and among pregnant women.

Five countries account for half of the world's newborn deaths per year: India (779,000), Nigeria (276,000), Pakistan (202,400), China (157,000), and the Democratic Republic of Congo (118,000). In 2012, eight of nine countries with death rates higher than 40 per 1,000 live births were in sub-Saharan Africa.

If current trends persist, it will be over a century before a baby born in Africa has the same likelihood of survival as a baby born in North America or Europe, according to the researchers.

They also found that 40 percent of newborn deaths and stillbirths occur on the day of birth, and nearly 46 percent of mothers' deaths occur in the same period. Preterm birth is a major cause of newborn death, and a preterm baby born in Africa is 11 times more likely to die than one born in North America or Europe.

"Our findings show that there is an urgent unmet need to provide timely, high-quality care for both mother and baby around the time of birth," Lawn said.

"Each year one million babies die on their birth day -- their only day," she added. "In the coming decades, improvements in child survival, development and human capital depend on ensuring a healthy start for every newborn baby -- the citizens and workforce of the future," she concluded.

SOURCE: The Lancet, news release, May 19, 2014

HealthDay