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The global network: a prospective study of stillbirths in developing countries
Elizabeth M McClure1, Linda L Wright, Robert L Goldenberg
1Research Triangle Institute, Research Triangle Park, NC 27709, USA. mcclure@rti.org
American Journal of Obstetrics and Gynecology
|September 11, 2007
Summary
Stillbirth rates in developing countries are significantly higher than in developed nations, particularly for births over 1000g. Improving access to skilled providers and hospital deliveries could reduce these preventable stillbirths.
Area of Science:
- Global Health
- Maternal and Child Health
- Perinatal Epidemiology
Background:
- Stillbirth rates in developing countries are a critical public health concern.
- Existing data often underestimates the true burden due to differing definitions and settings.
Purpose of the Study:
- To determine stillbirth rates in community settings across multiple developing countries.
- To identify factors associated with increased stillbirth risk.
Main Methods:
- Prospective evaluation of community deliveries in 6 countries over 18 months.
- Definition of stillbirth: births > 1000g with no signs of life.
- Inclusion of 60,324 deliveries.
Main Results:
- Stillbirth rates varied widely, from 9/1000 in Argentina to 34/1000 in Pakistan.
- Higher rates linked to less skilled providers, out-of-hospital births, and low cesarean section rates.
- Maceration observed in 17.2% of stillbirths, suggesting intrapartum deaths.
Conclusions:
- Stillbirth rates in these developing countries are substantially higher than in developed nations.
- The disparity is even greater when considering all stillbirths, including those under 1000g.
- Improved access to quality institutional delivery services is crucial for reducing stillbirths.
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