Stillbirths: recall to action in high-income countries.


Flenady, V; Wojcieszek, AM; Middleton, P; Ellwood, D; Erwich, JJ; Coory, M; Khong, TY; Silver, RM; Smith, GC; Boyle, FM; Lawn, JE; Blencowe, H; Leisher, SH; Gross, MM; Horey, D; Farrales, L; Bloomfield, F; McCowan, L; Brown, SJ; Joseph, KS; Zeitlin, J; Reinebrant, HE; Ravaldi, C; Vannacci, A; Cassidy, J; Cassidy, P; Farquhar, C; Wallace, E; Siassakos, D; Heazell, AE; Storey, C; Sadler, L; Petersen, S; Frøen, JF; Goldenberg, RL; Lancet Ending Preventable Stillbirths study group, ; Lancet Stillbirths In High-Income Countries Investigator Group, ; , COLLABORATORS; Flenady, V; Frøen, JF; Kinney, MV; de Bernis, L; Lawn, JE; Blencowe, H; Heazell, A; Leisher, SH; Ruidiaz, J; Carvalho, A; Dahlstrom, J; East, C; Fox, JP; Gibbons, K; Ibiebele, I; Kildea, S; Gardener, G; Lourie, R; Wilson, P; Gordon, A; Jennings, B; Kent, A; McDonald, S; Merchant, K; Oats, J; Walker, SP; Raven, L; Schirmann, A; de Montigny, F; Guyon, G; Blondel, B; de Wall, S; Bonham, S; Corcoran, P; Cregan, M; Meaney, S; Murphy, M; Fukui, S; Gordijn, S; Korteweg, F; Cronin, R; Masson, V; Culling, V; Usynina, A; Pettersson, K; van Gogh, S; Bichara, B; Bradley, S; Ellis, A; Downe, S; Draper, E; Manktelow, B; Scott, J; Smith, L; Stones, W; Lavender, T; Cacciatore, J; Duke, W; Fretts, RC; Gold, KJ; McClure, E; Reddy, U; (2016) Stillbirths: recall to action in high-income countries. Lancet, 387 (10019). pp. 691-702. ISSN 0140-6736 DOI: 10.1016/S0140-6736(15)01020-X

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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.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 26794070
Web of Science ID: 369837100028
URI: http://researchonline.lshtm.ac.uk/id/eprint/2534208

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