Temporal trends in stillbirth over eight decades in England and Wales: A longitudinal analysis of over 56 million births and lives saved by improvements in maternity care

Gbenga A Kayode*, Andrew Judge, Christy Burden, Cathy Winter, Timothy J Draycott, Basky Thilaganathan, Erik Lenguerrand

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
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Abstract

Background
Considering the public health importance of stillbirth, this study quantified the trends in stillbirths over eight decades in England and Wales.

Methods
This longitudinal study utilized the publicly available aggregated data from the Office for National Statistics that captured maternity information for babies delivered in England and Wales from 1940 to 2019. We computed the trends in stillbirth with the associated incidence risk difference, incidence risk ratio, and extra lives saved per decade.

Results
From 1940-2019, 56 906 273 births were reported. The stillbirth rate declined (85%) drastically up to the early 1980s. In the initial five decades, the estimated number of deaths per decade further decreased by 67 765 (9.49/1000 births) in 1940-1949, 2569 (0.08/1000 births) in 1950-1959, 9121 (3.50/1000 births) in 1960-1969, 15 262 (2.31/1000 births) in 1970-1979, and 10 284 (1.57/1000 births) in 1980-1989. However, the stillbirth rate increased by an additional 3850 (0.58/1000 births) stillbirths in 1990-1999 and 693 (0.11/1000 births) stillbirths in 2000-2009. The stillbirth rate declined again during 2010-2019, with 3714 fewer stillbirths (0.54/1000 births). The incidence of maternal age <20 years reduced over time, but pregnancy among older women (>35 years) increased.

Conclusions
The stillbirth rate declined drastically, but the rate of decline slowed in the last three decades. Though teenage pregnancy (<20 years) had reduced, the prevalence of women with a higher risk of stillbirth may have risen due to an increase in advanced maternal age. Improved, more personalised care is required to reduce the stillbirth rate further.
Original languageEnglish
Article number04072
Pages (from-to)1-7
JournalJournal of Global Health
Volume12
DOIs
Publication statusPublished - 17 Sept 2022

Bibliographical note

Funding Information:
Acknowledgements: The authors appreciate Tommy’s, the United Kingdom, for funding study as part of their contribution towards reducing stillbirth in the United Kingdom. We express our gratitude to all other non-governmental organizations, Royal College of Midwives and Royal College of Obstetrics and Gynaecology. We are also particularly grateful for the suggestions from the Women’s Advisory Group at the Tommy’s National Centre for Maternity Improvement, in particular Fran Carroll, Elisha Nunhofer, Claire Storey and Maria Viner. Funding: This study was funded by the Tommy’s, the United Kingdom. The funder did not play any role in the design study, data collection, analysis, and reporting of this manuscript. Authorship contribution: All authors contributed to the conception, design, and data collection of the study. GAK, EL and AJ were involved in data analysis. GAK, EL and AJ drafted the article. All authors were involved in interpreting the data and critically reviewing the article. All authors gave approval of the final version for publication. Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare no relevant interests.

Publisher Copyright:
© 2022,Journal of Global Health. All Rights Reserved.

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