High number of stillbirths in industrial nations

Still too many deaths in the industrial nations

14.04.2011

Stillbirths are relatively widespread, especially in developing countries. But even in different industrial nations, the number of stillborn babies could be significantly reduced, report Vicki Flenady from the University of Queensland, Australia, and colleagues in the current issue of the journal „The Lancet“.

According to the World Health Organization, worldwide, more than 2.6 million stillbirths occur annually - an average of 7,000 a day, with 98 percent of cases occurring in the poorer nations. Especially in South Asia and sub-Saharan Africa, stillbirths are still a widespread phenomenon. But even in the modern industrialized nations, the number of stillbirths could be significantly reduced, according to the experts.

France Industrial nation with the highest death rate
According to the WHO definition, all babies born dead in or after the 28th week of gestation are considered stillbirth. In the course of better medical care, the number of stillbirths in the industrialized nations has declined significantly since the 1940s, but has declined in many industrialized nations for several years, said the Australian scientists in their current publication. According to research by Vicki Flenady and colleagues, the rate of stillbirth is currently the lowest in Finland and Singapore by far. Only two out of every 1,000 babies are born dead after the 28th week of pregnancy. Approximately twice as many stillbirths were recorded according to the researchers, with 3.9 out of 1,000 in France. This makes France sad leader of the developed world in terms of stillbirths. At a rate of 2.4 stillbirths per 1,000 newborns, Germany is relatively well compared to other industrialized nations. However, the low rates of stillbirths in the industrialized nations only become quite clear when the countries with the highest stillbirth rates are considered in parallel. According to the WHO, for example, there are 47 stillbirths in 1,000 babies in New Zealand and 42 in Nigeria 42.

Potential for action in stillbirths
The difference in stillbirth rates in the developed world illustrates, according to the Australian researchers, that there is still considerable potential for action here. Above all, the unhealthy lifestyle and previous caesarean sections significantly increase the risk of stillbirth in the industrialized nations, said the scientists of the University of Queensland. Alcohol, nicotine and obesity are, according to the experts in most industrialized countries, major risk factors that promote the occurrence of stillbirths. In each case, the risk of stillbirth increases by at least 40 percent in the case of tobacco or alcohol consumption by the mothers, said the researchers around Vicki Flenady. In addition, other factors would increase the risk of stillbirth. Thus, the risk of stillbirth in expectant mothers aged 35 and over is 65 percent higher than for women under the age of 35. Also, the risk of stillbirth at the first pregnancy is significantly higher than next. Pregnant women who have already undergone caesarean delivery are also at increased risk, the Australian scientists said. However, according to the experts, obesity is most unfavorable and since 58 percent of women of childbearing age in the industrialized nations are overweight, this is associated with a significant number of stillbirths.

Numerous risk factors for stillbirth
According to the researchers, the possible causes of stillbirth are highly complex and may, in addition to maternal behavior, also be caused by direct damage or malformations of the child. However, the risk factors that are determined by the mother's organism include, for example, infections such as listeriosis, toxoplasmosis and cytomegalovirus or diseases such as diabetes mellitus and malformations of the uterus. Even complications such as womb tears or amniotic fluid embolisms can cause a stillbirth. In addition, psychosocial stress is considered a significant risk factor. (Fp)

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Image: Lisa Black