WUNRN
STILLBIRTHS - Lancet Series Responds to the
2.6 Million Stillbirths Yearly
April 14th, 2011 - The Lancet has launched a new series on
stillbirths. In six series papers, two research articles, and eight
comments, global health experts illustrate how stillbirths have been rendered
invisible in the global health arena, and what can be done to bring these
tragedies to light. Through new analysis of stillbirth occurrences,
success stories and lessons learned from around the world, with a focus on the
poor and marginalized, The Lancet Stillbirth Series is a call to action that we
cannot afford to ignore.
An Invisible Tragedy
New evidence suggests that stillbirths are the fifth most-common cause
of death worldwide. Previously, documenting the exact number of
stillbirths had been difficult as the UN system did not collect data on these
deaths. In society, stillbirths are rarely mourned publically,
particularly in low-income countries.
Despite this widespread neglect, at least 2.6 million third-trimester
stillbirths occur each year, 98% of them in low-income and middle-income
countries. African women are 24 times more likely to have a stillbirth at the
time of delivery than a woman in a developed country. Rural women are
particularly vulnerable as well, with two-thirds of stillbirths occurring in
rural settings where skilled birth attendants are not readily available.
Ten countries account for 66% of stillbirths worldwide:
1. India
2. Pakistan
3. Nigeria
4. China
5. Bangladesh
6. Democratic Republic of Congo
7. Ethiopia
8. Indonesia
9. Tanzania
10. Afghanistan
The top five causes of stillbirths are closely related to the top killers of mothers and newborns:
1. Childbirth complications
2. Maternal infections in pregnancy
3. Maternal disorders, especially hypertension and diabetes
4. Fetal growth restriction
5. Congenital abnormalities
What needs to be done?
The number of stillbirths worldwide has only declined by 1.1% per year from
1995 to 2006. “Stillbirths often go unrecorded, and are not seen as a
major public health problem,” says Flavia Bustreo, M.D., Assistant
Director-General for Family and Community Health at the World Health
Organization. “Yet, stillbirth is a heartbreaking loss for women and
families. We need to acknowledge these losses and do everything we can to
prevent them.”
There is hope in the success stories of China and Mexico, where interventions
resulted in stillbirth rates decreasing by 50% since 1995. In examining
these countries and other success stories around the world, experts have found
the following interventions as critical to decreasing stillbirths:
|
Intervention |
Stillbirths
averted |
|
Comprehensive
emergency obstetric care |
696,000 |
|
Syphilis
detection and treatment |
136,000 |
|
Comprehensive
emergency obstetric care |
696,000 |
|
Detection
and management of fetal growth restriction |
107,000 |
|
Detection
and management of hypertension during pregnancy |
57,000 |
|
Identification
and induction for mothers with greater than 41 weeks gestation |
52,000 |
|
Malaria
prevention, including bednets and drugs |
35,000 |
|
Folic
acid fortification before conception |
27,000 |
|
Detection
and management of diabetes in pregnancy |
24,000 |
In total, these interventions could avert up to 1.1 million
stillbirths. According to Dr. Zulfiqar Bhutta, an additional 1.6
million mothers and newborn lives could be saved if five additional
interventions were added, including antenatal steroids and neonatal
resuscitation. Averting stillborn deaths is within our reach. “By shining
a spotlight on the tragic toll of stillbirths, we can prevent stigma, relieve
suffering and make greater progress to improve the health of every woman and
every newborn,” says Purnima Mane, Deputy Executive Director of United Nations
Population Fund.
_____________________________________________________________________
Launched in London, New York,
Hobart, Geneva, New Delhi, Florence, and Cape Town on April 14, 2011
Around 2.6 million stillbirths (the death of a baby at 28 weeks’ gestation or
more) occur each year. Although 98% of these deaths take place in low-income
and middle-income countries, stillbirths also continue to affect wealthier
nations, with around 1 in every 300 babies stillborn in high-income countries.
The Series highlights the rates and causes of stillbirth globally, explores
cost-effective interventions to prevent stillbirths (as well as maternal and neonatal
deaths), and sets key actions to halve stillbirth rates by 2020.....
Series Articles
National,
regional, and worldwide estimates of stillbirth rates in 2009 with trends since
1995: a systematic analysis
Major
risk factors for stillbirth in high-income countries: a systematic review and
meta-analysis
Series Papers