Document Detail


Stillbirths: Where? When? Why? How to make the data count?
MedLine Citation:
PMID:  21496911     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite increasing attention and investment for maternal, neonatal, and child health, stillbirths remain invisible-not counted in the Millennium Development Goals, nor tracked by the UN, nor in the Global Burden of Disease metrics. At least 2·65 million stillbirths (uncertainty range 2·08 million to 3·79 million) were estimated worldwide in 2008 (≥1000 g birthweight or ≥28 weeks of gestation). 98% of stillbirths occur in low-income and middle-income countries, and numbers vary from 2·0 per 1000 total births in Finland to more than 40 per 1000 total births in Nigeria and Pakistan. Worldwide, 67% of stillbirths occur in rural families, 55% in rural sub-Saharan Africa and south Asia, where skilled birth attendance and caesarean sections are much lower than that for urban births. In total, an estimated 1·19 million (range 0·82 million to 1·97 million) intrapartum stillbirths occur yearly. Most intrapartum stillbirths are associated with obstetric emergencies, whereas antepartum stillbirths are associated with maternal infections and fetal growth restriction. National estimates of causes of stillbirths are scarce, and multiple (>35) classification systems impede international comparison. Immediate data improvements are feasible through household surveys and facility audit, and improvements in vital registration, including specific perinatal certificates and revised International Classification of Disease codes, are needed. A simple, programme-relevant stillbirth classification that can be used with verbal autopsy would provide a basis for comparable national estimates. A new focus on all deaths around the time of birth is crucial to inform programmatic investment.
Authors:
Joy E Lawn; Hannah Blencowe; Robert Pattinson; Simon Cousens; Rajesh Kumar; Ibinabo Ibiebele; Jason Gardosi; Louise T Day; Cynthia Stanton;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-13
Journal Detail:
Title:  Lancet     Volume:  377     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-25     Completed Date:  2011-05-03     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  1448-63     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Saving Newborn Lives/Save the Children, Cape Town, South Africa. joylawn@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Cause of Death
Data Collection
Developed Countries / statistics & numerical data
Developing Countries* / statistics & numerical data
Epidemiologic Measurements
Female
Fetal Death / classification
Humans
Maternal Mortality
Pregnancy
Pregnancy Complications
Stillbirth / epidemiology*
Investigator
Investigator/Affiliation:
J Fredrik Frøen / ; Joy E Lawn / ; Zulfiqar A Bhutta / ; Robert Pattinson / ; Vicki Flenady / ; Robert L Goldenberg / ; Monir Islam /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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