HQ Team
November 10, 2024: One stillbirth occurs every 10 seconds and one-third of these occur between 20 and 28 weeks gestation, according to data from the Institute for Health Metrics and Evaluation.
The World Health Organization had previously recommended including stillbirths at 28 weeks or greater in international stillbirth statistics. âThe shortcoming of this approach is that it leaves all fetal deaths between 20 and 28 weeks gestation uncounted,â the IHME stated.
Stillbirths are distinguished from miscarriages by how far along the pregnancy is â miscarriages occur before 20 weeks gestation. Stillbirth, the loss of a fetus before or during delivery, is a devastating and often avoidable pregnancy outcome.
According to the study by IHME, a public health research institute of the University of Washington in Seattle, stillbirths down to 20 weeks gestation cut-off period were what previous global assessments used earlier.
The study found that approximately three million stillbirths occurred globally in 2021 after at least 20 weeks gestation, averaging about 8,328 per day. This rate meant, worldwide, one stillbirth happened every 10 seconds.
South Sudan
In 2021, South Sudan recorded the highest stillbirth rate (68.3 stillbirths per 1,000 births). There, only about half of pregnant women (57.6%) received at least one antenatal care visit with a skilled provider, and less than a quarter (21.9%) received at least four.Â
The largest deterrents to accessing antenatal care are reportedly long distances for travel and a lack of transportation to health facilities, as well as the inability to pay healthcare fees.
In comparison, in Slovenia, which had a low rate of 5.1 stillbirths per 1,000 births, almost all women received at least four antenatal care visits. Since 1998, preventative health-care policy in Slovenia has required at least 10 antenatal care visits and three ultrasounds during pregnancy.
More than 75% of all stillbirths at 20 weeks or longer gestation occurred in South Asia and sub-Saharan Africa in 2021 âan increase of ten percentage points from 1990.
Cardiotocography
Comprehensive efforts to record and count all stillbirths are essential for informing public health interventions aimed at preventing them.Â
âWe believe that using a lower gestational age cutoff for counting stillbirths is justified by improvements in technology and advancements in neonatal care that support extremely premature babies and increase their chances of survival, even when born as early as 21 weeks and one day,” according to an IHME statement.
One of these innovations is cardiotocography, a technique that uses an elastic belt to continuously measure a baby’s heartbeat and contractions.Â
Computerised monitoring of a baby’s status in the womb has been shown to reduce infant deaths around the time of birth by 80% relative to when this approach is done manually with pen and paper.
The global community’s focus on and efforts toward reducing stillbirths have led to annual decreases since 1990, but the total number of stillbirths affecting pregnant people and families remains high.
Antenatal care
Reductions in stillbirths have not kept pace with global declines in neonatal and under-5 mortality.
Though the estimated number of stillbirths at 20 weeks gestation or longer decreased by about 40% over the past three decades, this reduction was notably less than the approximate 45% decline in neonatal (less than 28 days old) deaths over the same period.
Those trends indicate too little prioritization of stillbirth prevention, including resources for and attention toward maternal health care before and during pregnancy.
In 2021, in 11 countriesâincluding Bangladesh, Papua New Guinea, Somalia, and Yemenâfewer than 80% of mothers received one antenatal care visit during their pregnancy. Further, in 66 countries, fewer than 80% of mothers had four antenatal care visits.
The study was published in The Lancet recently as part of the IHMEâs Global Burden of Disease study.
