A series of papers in The Lancet today paint a surprisingly grim picture of stillbirths, both in developing nations and high-income countries like the U.S.
In the U.S., 1 in 200 pregnancies that make it to week 22 end in stillbirths (that struck me as an alarmingly high number — i’d never heard that statistic before).
The researchers estimate that worldwide, 2.6 million stillbirths occur each year — 7,000 a day (more than AIDS and malaria combined). The group used the World Health Organization definition of stillbirth, which is the death of a fetus in the womb after 28 weeks gestation.
In their paper, the researchers point out that in the U.S. we think stillbirths are a thing of the past. On the flip side, the common perception is that in developing countries, stillbirths are almost an unpreventable fact of life. They argue otherwise on both counts.
Here are the main contributors to stillbirths in the U.S., and what the researchers say we can do about the worldwide problem:
In the U.S., approximately 26,000 stillbirths occur each year. Among high-income countries, Norway has the lowest rate and the UK, the highest.
The Lancet studies attribute a lot of the fetal deaths to the usual suspects: obesity is the biggest risk factor in stillbirths, heavy smoking nearly doubles the odds, and advanced maternal age. From the report:
Maternal age of more than 35 years is also an important factor that is associated with a 65% increase in the odds of stillbirth and could be responsible for almost 4226 stillbirths in high-income countries each year. Maternal age is somewhat modifiable through increased awareness of the associated risk and family planning.
Yikes, that sounds bad. But let’s remember, that doesn’t mean you have a 65 percent chance of a stillbirth (obviously), it means that an already relatively low rate (if you can call 1/200 low) is increased by 65 percent.
Worldwide, especially in areas like sub Saharan Africa and South Asia, the researchers urge widespread interventions like:
Folic acid fortification in staple products like wheat flour
Malaria treatment (insecticide bed nets and antimalarial pills)
Management of diabetes and hypertension in pregnancy
Monitoring and induction of labor after 41 weeks
More skilled care for newborns and emergency obstetric care
Do any of these numbers surprise you?