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Stillbirths: The Hidden Birth Asphyxia - US and Global Perspectives
Robert L Goldenberg1, Margo S Harrison1, Elizabeth M McClure2
1Department of Obstetrics and Gynecology, Columbia University, 622 West 168th Street, PH 16-66, New York, NY 10032, USA.
Clinics in Perinatology
|August 16, 2016
Summary
Stillbirths are a common adverse pregnancy outcome, more frequent in low-income nations. Causes and timing vary globally, with fetal asphyxia being a common final pathway.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Global Health
Background:
- Stillbirths represent a significant adverse pregnancy outcome globally.
- Disparities exist, with higher stillbirth rates in low- and middle-income countries (LMICs) compared to high-income countries (HICs).
- Timing and associated conditions of stillbirth differ between LMICs and HICs.
Purpose of the Study:
- To summarize the epidemiology and associated factors of stillbirth.
- To highlight global variations in stillbirth occurrence and causes.
Main Methods:
- Literature review and synthesis of existing data on stillbirth.
- Comparative analysis of stillbirth patterns in different income settings.
Main Results:
- Stillbirths are more prevalent in LMICs than HICs.
- In HICs, stillbirths predominantly occur early preterm; in LMICs, they occur at term or late preterm.
- Associated factors in LMICs include prolonged labor, preeclampsia, and fetal growth restriction, while placental abnormalities are common in HICs.
- Fetal asphyxia is identified as the most frequent final pathway to stillbirth worldwide.
Conclusions:
- Stillbirths present distinct epidemiological profiles in LMICs and HICs.
- Addressing risk factors and improving obstetric care in LMICs is crucial for stillbirth prevention.
- Fetal asphyxia warrants targeted interventions to reduce global stillbirth rates.
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