Stillbirth rates: delivering estimates in 190 countries.

Area of Science:

• Global Health
• Perinatal Epidemiology
• Demography

Background:

• Limited global data exists for stillbirths, defined as fetal deaths in the last 12 weeks of pregnancy.
• Neonatal mortality data is scarce, and systematic global stillbirth estimates are absent.
• This study aimed to estimate stillbirth rates and numbers for 190 countries in 2000.

Purpose of the Study:

• To systematically identify and assess available stillbirth data from diverse sources.
• To develop a robust model for estimating national stillbirth rates and associated uncertainties.
• To provide the first comprehensive global estimates of stillbirths for the year 2000.

Main Methods:

• Data sources included vital registration, demographic and health surveys (DHS), and published/unpublished studies.
• A new analysis of contraceptive calendar data was used for DHS.
• A random effects regression model predicted national stillbirth rates and uncertainty intervals.

Main Results:

• Data from 44 countries (vital registration), 16 countries (DHS), and 103 countries (studies) met inclusion criteria.
• Estimated stillbirth rates varied significantly, from 5 per 1000 in high-income countries to 32 per 1000 in South Asia and sub-Saharan Africa.
• The global estimated number of stillbirths was 3.2 million (uncertainty range 2.5–4.1 million), likely an underestimate.

Conclusions:

• Stillbirths are a significant global health issue, particularly in low-resource settings.
• A critical lack of usable data exists in regions with the highest stillbirth burden, compounded by under-reporting.
• Improving stillbirth data collection is essential for effective public health interventions and policy development.