Stillbirths: Recall to action in high-income countries

Vicki Flenady*, Aleena M. Wojcieszek, Philippa Middleton, David Ellwood, Jan Jaap Erwich, Michael Coory, T. Yee Khong, Robert M. Silver, Gordon C S Smith, Frances M. Boyle, Joy E. Lawn, Hannah Blencowe, Susannah Hopkins Leisher, Mechthild M. Gross, Dell Horey, Lynn Farrales, Frank Bloomfield, Lesley McCowan, Stephanie J Brown, K. S. JosephJennifer Zeitlin, Hanna E. Reinebrant, Claudia Ravaldi, Alfredo Vannacci, Jillian Cassidy, Paul Cassidy, Cindy Farquhar, Euan Wallace, Dimitrios Siassakos, Alexander E P Heazell, Claire Storey, Lynn Sadler, Scott Petersen, J. Frederik Frøen, Robert L. Goldenberg

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

207 Citations (Scopus)
468 Downloads (Pure)

Abstract

Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.

Original languageEnglish
Pages (from-to)691-702
Number of pages12
JournalLancet
Volume387
Issue number10019
Early online date18 Jan 2016
DOIs
Publication statusPublished - 13 Feb 2016

Keywords

  • Stillbirth
  • Perinatal mortality
  • High-income countries
  • Quality of care
  • Implementation
  • Perinatal audit
  • Classification
  • Bereavement care

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  • Cite this

    Flenady, V., Wojcieszek, A. M., Middleton, P., Ellwood, D., Erwich, J. J., Coory, M., Khong, T. Y., Silver, R. M., Smith, G. C. S., Boyle, F. M., Lawn, J. E., Blencowe, H., Leisher, S. H., Gross, M. M., Horey, D., Farrales, L., Bloomfield, F., McCowan, L., Brown, S. J., ... Goldenberg, R. L. (2016). Stillbirths: Recall to action in high-income countries. Lancet, 387(10019), 691-702. https://doi.org/10.1016/S0140-6736(15)01020-X