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Lancet. 2016 Feb 13;387(10019):691-702. doi: 10.1016/S0140-6736(15)01020-X. Epub 2016 Jan 19.

Stillbirths: recall to action in high-income countries.

Author information

1
Mater Research Institute, University of Queensland, Brisbane, QLD Australia; International Stillbirth Alliance, NJ, USA. Electronic address: vicki.flenady@mater.uq.edu.au.
2
Mater Research Institute, University of Queensland, Brisbane, QLD Australia; International Stillbirth Alliance, NJ, USA.
3
International Stillbirth Alliance, NJ, USA; Women's & Children's Health Research Institute, University of Adelaide, Adelaide, SA, Australia.
4
International Stillbirth Alliance, NJ, USA; Griffith University and Gold Coast University Hospital, Gold Coast, QLD, Australia.
5
International Stillbirth Alliance, NJ, USA; University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
6
International Stillbirth Alliance, NJ, USA; Murdoch Childrens Research Institute, Melbourne, VIC, Australia.
7
International Stillbirth Alliance, NJ, USA; SA Pathology, University of Adelaide, Adelaide, SA, Australia.
8
International Stillbirth Alliance, NJ, USA; University of Utah Health Sciences Center, Salt Lake City, UT, USA.
9
National Institute for Health Research, Biomedical Research Centre and Cambridge University, Cambridge, UK.
10
School of Public Health, University of Queensland, Brisbane, QLD Australia; International Stillbirth Alliance, NJ, USA.
11
London School of Hygiene & Tropical Medicine, London, UK.
12
Hannover Medical School, Hannover, Germany; Zurich University of Applied Sciences, Institute for Midwifery, Winterthur, Switzerland.
13
Mater Research Institute, University of Queensland, Brisbane, QLD Australia; La Trobe University, Melbourne, VIC, Australia.
14
International Stillbirth Alliance, NJ, USA; Still Life Canada: Stillbirth and Neonatal Death Education, Research and Support Society, Vancouver, Canada; University of British Columbia, Vancouver, Canada.
15
Liggins Institute, Auckland, New Zealand.
16
International Stillbirth Alliance, NJ, USA; Liggins Institute, Auckland, New Zealand.
17
Murdoch Childrens Research Institute and General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, VIC, Australia.
18
University of British Columbia, Vancouver, Canada.
19
Institut National de la Santé et de la Recherche Médicale, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France.
20
International Stillbirth Alliance, NJ, USA; CiaoLapo Onlus, Charity for High-Risk Pregnancies and Perinatal Grief Support, Prato, Italy.
21
International Stillbirth Alliance, NJ, USA; CiaoLapo Onlus, Charity for High-Risk Pregnancies and Perinatal Grief Support, Prato, Italy; Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
22
International Stillbirth Alliance, NJ, USA; Umamanita, Girona, Spain.
23
University of Auckland, Auckland, New Zealand.
24
International Stillbirth Alliance, NJ, USA; Monash University, Melbourne, VIC, Australia.
25
International Stillbirth Alliance, NJ, USA; University of Bristol, Bristol, UK; Southmead Hospital, Bristol, UK.
26
International Stillbirth Alliance, NJ, USA; Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK; St Mary's Hospital, Central Manchester University Hospitals, NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
27
International Stillbirth Alliance, NJ, USA.
28
Mater Research Institute, University of Queensland, Brisbane, QLD Australia; Mater Health Services, Brisbane, QLD, Australia.
29
Mater Research Institute, University of Queensland, Brisbane, QLD Australia; Griffith University and Gold Coast University Hospital, Gold Coast, QLD, Australia; Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway; Center for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway.
30
Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.

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.

PMID:
26794070
DOI:
10.1016/S0140-6736(15)01020-X
[Indexed for MEDLINE]

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