To estimate the incidence of stillbirth, explore the associated maternal and fetal factors and to evaluate the most appropriate classification of stillbirth for a multiethnic population. Mar 22, 2018 newborn deaths comprise nearly half of under5 deaths in ghana, despite the fact that skilled birth attendants sbas are present at 68% of births, which implies that evidencebased care during labor, birth and the immediate postnatal period may be deficient. Context stillbirths account for almost half of us deaths from 20 weeks gestation to 1 year of life. The objective of this analysis was to determine whether. Most eligible pregnant women do not receive the minimum three recommended doses of intermittent preventive treatment with sulfadoxinepyrimethamine iptpsp. Parents experiences about support following stillbirth and. Every year, malaria in pregnancy contributes to approximately 20% of stillbirths in subsaharan africa and 10,000 maternal deaths globally. Maternal going to sleep position and late stillbirth.
However, 95% of these deaths occurred in lmics with the largest numbers reported in south asia and subsaharan africa 9,10. Population 92 218 normally formed singletons including 389 stillbirths from 24 weeks of gestation, delivered during 200911. The elevated risk in the black race may be attributed to higher rates of diabetes and preeclampsia, prom and decolmentation compared to white women. Evaluation of maternal health service indicators in urban. Tracking facilitybased perinatal deaths in tanzania.
Accelerating newborn survival in ghana through a lowdose. A novel contribution of this study to causal inference on the topic is the approach. In developed countries stillbirth is one of the few potentially avoidable maternal and child health complications that have not declined in recent decades. Factors associated with insecticidetreated net usage. This study aimed to identify factors at individual and community level influencing insecticidetreated net itn usage among groups of women of childbearing age wocba in malawi. Pregnancy loss, including spontaneous abortion miscarriage and stillbirth, is the most severe adverse pregnancy outcome.
Abstractthe developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes. Risk factors include a mothers age over 35, smoking, drug use, use of assisted reproductive technology, and first pregnancy. Prepregnancy risk factors for stillbirth that have been found to be more frequent among african americans include young maternal age and multiple. Twentyone semistructured interviews were carried out. Multiple factors have been associated with stillbirths in. Placental pathologies and infection associated with preterm birth are linked to a substantial proportion of stillbirths. Sep 15, 2016 lawn je, blencowe h, waiswa p, the lancet ending preventable stillbirths series study group with the lancet stillbirth epidemiology investigator group, et al. Stillbirth stillbirth rate referral hospitals caesarean section nigerian women.
Globally, the number of perinatal deaths decreased from 5. Finland and singapore have the lowest stillbirth rates, two per 1,000. Rates, risk factors, and acceleration towards 2030, included multiple centres like the centre for maternal, adolescent, reproductive and child health, london. Although, bangladesh remained one of the top ten countries in the world for high maternal deaths, early 2015 progress towards mdg5 was on track and maternal mortality rate was reduced from 322 to 194 per 100,000 live births in a decade 20012010. Rates of intrapartum stillbirths are a measure of the quality of care during labor. Professor vicki flenady is the director of the centre of research excellence in stillbirth stillbirth cre, based at mater research the university of queensland. Progress in the reduction of stillbirths and meeting 2030 targets. Most common causes, risk factors for stillbirth date.
Stillbirth is typically defined as fetal death at or after 20 to 28 weeks of pregnancy depending. The united states ranks 17th out of 193 countries, with three. Rates, risk factors, and acceleration towards 2030 an estimated 26 million third trimester stillbirths occurred in 2015. Good quality care is supported by a functional heath system. Ghana statistical service gss, ghana health service ghs, and icf international. Appropriate preconception care and quality antenatal.
Dec 14, 2011 studies identify stillbirth risk factors, causes december 14, 2011 6. Information on cases stillbirths were obtained from. Resource centres publications 1 30 indepth policy lessons. Most common causes, risk factors for stillbirth sciencedaily. The objective of this study was to explore the risk factors for stillbirths, particularly those related to a health system. We assessed the effect of a lowdose, highfrequency ldhf training approach on longterm evidencebased skill retention among sbas and. Findings in stillbirths associated with placental disease. Dec 14, 2011 most common causes, risk factors for stillbirth date. Parents experiences about support following stillbirth. In tanzania 51,000 newborn deaths and 43,000 stillbirths occur every year. The every newborn action plan has the target of 12 or fewer stillbirths per births in. The objective of this analysis was to determine whether women randomized to group antenatal. But the increase in risk wasnt equal across all groups of women, or all stages of pregnancy. Mcclure em, mathai m, cousens s, for the lancet ending preventable stillbirths series study group with the lancet stillbirth epidemiology investigator group 2016.
Studies identify stillbirth risk factors, causes december 14, 2011 6. Aug 09, 2017 five lancet papers addressing various aspects. Challenging the assumption that interpregnancy interval causes. Froen jf, friberg ik, lorne je, et al, stillbirths, progress and unfinished business, lancet 2016, vol 387, pp 574 to 586, published online 18 january 2016 lore je, blencowe h, waiswa p, et al, stillbirths. Adverse pregnancy outcomes among women presenting at. At 16 stillbirths per 1,000, ut betters national average. Joy elizabeth lawn frcpch fmedsci is a professor of maternal, reproductive and child health. In addition, obesity, smoking, infections and blood concentration, as well as medical disorders of mothers were. The risk was not increased with going to sleep on the right side and. Stillbirth is often defined as fetal death after 24 weeks of gestation, but a fetus greater than any combination of 16, 20, 22, 24, or 28 weeks gestational age and 350 g, 400 g, 500 g, or g birth weight may be considered stillborn depending on local law. Ijerph free fulltext perinatal mortality in south asia. Stillbirth may be suspected when no fetal movement is felt.
The every newborn action plan enap targets national stillbirth rates sbrs of 12 or fewer stillbirths per births by 2030. Trend of stillbirth rates and the associated risk factors. Risk factors include a mothers age over 35, smoking, drug use, use of assisted. A multivariable model was developed using a hierarchical approach with factors that had different distribution in cases and controls in bivariate analyses p maurice blackburn lawyers. The number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the millennium development goals. Overall, greater obesity was linked with greater risk of stillbirth, with a 10unit increase in body mass index equivalent to a 1. Stillbirth is typically defined as fetal death at or after 20 to 28 weeks of pregnancy depending on the source. Medline, cinahl, embase, psycinfo, and scopus were searched for published studies which reported factors associated with perinatal mortality in south asia from 1 january 2000 to 20 march 2018. Effect of group versus individual antenatal care on uptake. Jan 29, 2020 every year, malaria in pregnancy contributes to approximately 20% of stillbirths in subsaharan africa and 10,000 maternal deaths globally. Pakistan and nigeria have the highest, at 46 and 42 per 1,000. We estimate sbrs and numbers for 195 countries, including trends.
Records and registrations of all births, stillbirths, neonatal, and maternal deaths in a health facility would substantially increase data availability. Figure 1 regional variation in population attributable risk of stillbirth for factors with adequate risk data and appropriate prevalence data, from lawn et al, stillbirths. Objective to determine the relation between stillbirths and risk factors that could be ascertained at the start of pregnancy, particularly the contribution of these factors to racial disparities. A mother sleeping on her back after 28 weeks of pregnancy may be a risk factor for stillbirth.
The main risk factors for these 3 adverse pregnancy outcomes included low gravidity primigravid women and young age. This is a retrospective populationbased study of stillbirth in a large tertiary unit. Studies identify stillbirth risk factors, causes cbs news. Jan 18, 2018 the stillbirth rate is an indicator of quality of care during pregnancy and delivery. Objective to assess the main risk factors associated with stillbirth in a multiethnic english maternity population. Jan 24, 20 objective to assess the main risk factors associated with stillbirth in a multiethnic english maternity population. Maternal obesity increases risk for stillbirth stanford. Most large studies of risk factors for stillbirth use vital statistics with limited data. Air pollution exposure during pregnancy and spontaneous. She is a nationally and internationally renowned clinical perinatal epidemiologist with specific expertise in stillbirth. She developed the epidemiological evidence for the worldwide policy and programming that looks to reduce neonatal deaths and stillbirths and works on largescale. Twentyone parents mothers and 8 fathers from 6 families.
This casecontrol study was conducted in two districts of bihar, india. Stillbirth is typically defined as fetal death at or after 20 to 28 weeks of pregnancy. A continuous influx of poor people to urban slums poses a challenge to bangladeshs health system as it has failed to tackle maternal morbidity and mortality. Factors influencing itn usage in malawi were assessed through interviews with 16, wocba 1549 years across 850 communities who participated in the 20152016 malawi demographic health survey. In 2015, an estimated 26 million babies uncertainty range 2430 million.
Joy e lawn, hannah blencowe, peter waiswa, agbessi amouzou, colin mathers. Prevalence and determinants of stillbirth in nigerian referral. Two studies by the stillbirth collaborative research network have. Perinatal loss is a traumatic and painful experience for parents, with biological, psychological, social, and spiritual implications. National population commission npc nigeria and icf international. Prevalence and determinants of stillbirth in nigerian. Rates, risk factors, and acceleration towards 2030. In addition, obesity, smoking, infections and blood concentration, as well as medical disorders of mothers were reported to be independent risk factors for stillbirths. Once the fetus has died, the mother may or may not have contractions and undergo childbirth or in some cases, a caesarean section. This was a qualitative study based on gadamers hermeneutic phenomenology. Inductive analysis was used to find themes based on the data. Worldwide prevention of most stillbirths is possible with improved health systems. Multiple factors have been associated with stillbirths including maternal age, noncommunicable diseases, and in. Je lawn, h blencowe, p waiswa, a amouzou, c mathers, d hogan.
Pdf rate and risk factors of stillbirth in pakistan. Mcclure em, mathai m, cousens s, for the lancet ending preventable stillbirths. Risk factors and classification of stillbirth in a middle. Data of each stillbirth with a gestational age 24 weeks in the year 2015 were collected. Adverse pregnancy outcomes were analyzed in relation to multiple factors such as, maternal age, gravidity, number of anc visits, malaria prevention spiptp and itn, known risk factors and delivery mode. Criteria for assigning cause of death for stillbirths and neonatal. In 2015, an estimated 26 million babies uncertainty range 2430 million died before birth during the last trimester of pregnancy.
Lancet stillbirths in highincome countries investigator group. Trend of stillbirth rates and the associated risk factors in. Despite the substantial global progress in improving child survival, perinatal mortality remains an urgent public health concern and progress made has been slower. Effect of group versus individual antenatal care on uptake of. An estimated 26 million third trimester stillbirths occurred in 2015 uncertainty range 2430 million. Vol 387 february 6, 2016 587 ending preventable stillbirths 2 stillbirths. The conditions that cause fetal asphyxia also contribute to neonatal mortality through birth. The stillbirth rate for our multiethnic population is 7. A stillbirth can result in the feeling of guilt in the mother. Association between stillbirth and risk factors known at. Logistic regression analysis on the determinants of.