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Stillbirths: recall to action in high-income countries.

Accepted version
Peer-reviewed

Repository DOI


Type

Article

Change log

Authors

Flenady, Vicki 
Wojcieszek, Aleena M 
Middleton, Philippa 
Ellwood, David 
Erwich, Jan Jaap 

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.

Description

Keywords

Attitude to Health, Data Accuracy, Delivery of Health Care, Developed Countries, Female, Gestational Age, Global Health, Health Policy, Healthcare Disparities, Hospice Care, Humans, Income, International Cooperation, Perinatal Mortality, Postnatal Care, Practice Guidelines as Topic, Pregnancy, Prenatal Care, Risk Factors, Stereotyping, Stillbirth

Journal Title

Lancet

Conference Name

Journal ISSN

0140-6736
1474-547X

Volume Title

387

Publisher

Elsevier BV
Sponsorship
Mater Research Institute – The University of Queensland provided infrastructure and funding for the research team to enable this work to be undertaken. The Canadian Research Chair in Psychosocial Family Health provided funding for revision of the translation of the French web-based survey of care providers.