First-ever Global Review Examines Measures to Prevent Over 3.2 Million Stillbirths Globally

A first-ever global review of potential interventions to avert stillbirths, especially in low-income countries, was published online at the open access journal BMC Pregnancy and Childbirth today, and is available at the following website Stillbirths – the global picture and evidence-based solutions. Lead investigators from the Aga Khan University (Karachi, Pakistan) and colleagues from Save the Children and Johns Hopkins Bloomberg School of Public Health (Baltimore, USA) reviewed evidence for the impact of these interventions and strategies for delivering them.

This collaborative research initiative was led by Professor Zulfiqar A. Bhutta, head of the Division of Maternal and Child Health (AKU), with Dr. Yawar Yakoob at Aga Khan University, Drs. Gary L. Darmstadt and Rachel A. Haws from Johns Hopkins Bloomberg School of Public Health and Dr. Joy E. Lawn of Save the Children's Saving Newborn Lives program.

"In high-income countries such as the U.S. and the U.K. there is increasing recognition of the problem of stillbirths since the progress to reduce stillbirths has been minimal compared to progress for neonatal deaths, and parent groups are increasingly active," said Dr. Joy Lawn. "In low-income countries, the numbers are overwhelming at around 9,000 a day, with 3,000 a day occurring during birth. Behind each death, families suffer the pain of loss, often compounded with guilt. Societal taboos keep this grief hidden. Studies show that even 20 years after experiencing a stillbirth, women have unresolved grief."

The release of the study coincides with the opening of an International Conference on Prematurity and Stillbirth. This event is bringing together global leaders in science, public health and policy to examine the neglected issues of prematurity and stillbirth. One of the conference goals is to develop a coordinated strategy for successfully preventing these devastating pregnancy outcomes, both of which are major concerns in low-, middle- and high-income countries. The conference is being convened by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), the Bill & Melinda Gates Foundation, March of Dimes, PATH, Save the Children, UNICEF, and the World Health Organization.

Every year 3.2 million stillbirths occur around the world; 98 percent take place in low- to middle-income countries. Stillbirths are still underreported and largely absent from data records and national policy making. The global burden of intrapartum stillbirths — stillbirths that take place during labor — is around 1 million, mostly in low- and middle-income countries, which is more than all child deaths from malaria worldwide. Despite this, the investment and attention given to tackling stillbirths is low.

Six Papers on Stillbirths

The BioMed Central supplement, Stillbirths – the global picture and evidence-based solutions, has been funded by Save the Children's Saving Newborn Lives program through a grant from the Bill & Melinda Gates Foundation, and consists of six papers:

• 3.2 Million stillbirths: Epidemiology and overview of the evidence review addresses the global burden, the epidemiology, risk factors and the causes of stillbirths and lays down the methodology and framework for this worldwide review.
• Reducing stillbirths: behavioural and nutritional interventions before and during pregnancy and Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy cover the behavioral and medical interventions used before and during pregnancy, which include interventions targeted at medical conditions and infections in the mother.
• Reducing stillbirths: screening and monitoring during pregnancy and labour focuses on screening and monitoring interventions during pregnancy and labor, including ultrasound and Doppler studies, managing maternal diabetes, among other illnesses.
• Reducing stillbirths: interventions during labour deals with the evidence of interventions during labor.
• Delivering interventions to reduce the global burden of stillbirths: improving service supply and community demand examines health system solutions, including training health workers in facilities and also at the community level to improve care during pregnancy and childbirth.

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