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Causes and temporal changes in nationally collected stillbirth audit data in high-resource settings
Tom Norris1, Bradley N Manktelow2, Lucy K Smith2
1Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK.
Seminars in Fetal & Neonatal Medicine
|February 19, 2017
Summary
National stillbirth audits in the UK, New Zealand, and the Netherlands show declining stillbirth rates. However, care failures are common, highlighting the need for standardized stillbirth classification and improved antenatal care globally.
Area of Science:
- Perinatal epidemiology
- Public health policy
- Maternal-fetal medicine
Background:
- Stillbirth remains a significant concern in high-income countries.
- National stillbirth audit programmes are not widespread.
- Existing data on stillbirth trends and causes are limited by classification variations.
Purpose of the Study:
- To evaluate stillbirth rates and trends in countries with national audit programmes.
- To identify common factors contributing to stillbirths, including care deviations.
- To assess the impact of audit programmes on stillbirth rates and inform future strategies.
Main Methods:
- Analysis of data from national stillbirth audit programmes in the UK, New Zealand, and the Netherlands (1993-2014).
- Review of stillbirth classifications, causes of death, and identified risk factors.
- Comparison of stillbirth rates over the audit periods.
Main Results:
- Steady declines in annual stillbirth rates were observed in all three countries.
- Unexplained stillbirths constitute the largest category; intrapartum-related stillbirths showed a decline.
- Up to 50% of reviewed stillbirths involved deviations from established care standards and guidance.
Conclusions:
- National stillbirth audits are associated with declining stillbirth rates, potentially due to improved antenatal care recommendations.
- Significant proportions of stillbirths are linked to failures in care delivery.
- International standardization of stillbirth classification and data collection is crucial for accurate comparisons and effective interventions.
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