Commentary: reducing the world's stillbirths

By Joy Lawn, M. Yakoob, Rachel A. Haws, Tanya Soomro, G. Darmstadt, Z. Bhutta, A. Bhutta, L. Darmstadt. BMC Pregnancy and Childbirth, 2009

634 citations recorded by the source corpus.

One of the major success stories of modern obstetrics in high-income countries in the last 5 decades is the reduction of stillbirths from rates as high as 50 per 1000 births to about 5 per 1000 births today. Fetal mortality associated with obstructed labour, asphyxia, hypertension, diabetes, Rh disease, placental abruption, post-term pregnancies and infections such as syphilis all have declined. Much of this success has occurred in term births in the intrapartum period so that most stillbirths in high-income countries now occur in the antepartum period and are pre-term. Current stillbirth rates in many low- and middle-income countries, and especially in those areas within the countries with poorly functioning health systems, approximate those seen in high-income countries 50 years ago. A major difference between the stillbirths occurring in high-income countries and those occurring elsewhere is the preponderance of late pre-term, term and intrapartum stillbirths in low-resource countries. Those stillbirths should be relatively easy to prevent by known risk assessment methods and prompt delivery, often by Cesarean section. This commentary addresses an extensive six-paper review of stillbirths with an emphasis on low- and middle-income countries. Among the conclusions are that while a number of interventions have been shown to be effective in reducing stillbirths, unless there is a functioning health system in which these interventions can be implemented, the potential for a sustainable and substantial reduction in stillbirth rates will not be reached.

Subfields: General Health Professions, Obstetrics and Gynecology, Pediatrics, Perinatology and Child Health

View Paper: https://www.semanticscholar.org/paper/5e5a2a955874f03213dc49f9a44cbdd5f985999a