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Stillbirth burden in Europe ‘may be under-reported’

One in three stillbirths are not being officially recognised in European international comparisons, it is claimed.
One in three stillbirths are not being officially recognised in European international comparisons, it is claimed. One in three stillbirths are not being officially recognised in European international comparisons, it is claimed.

Europe’s stillbirth burden may be greatly underestimated because of the confused way the tragic events are recorded, a study suggests.

Authors of the report say at least a third of stillbirths are not being recognised in international comparisons.

The problem arises because at an international level, the World Health Organisation sets a threshold of 28 weeks of pregnancy for identifying stillbirths.

But individual countries record stillbirths occurring after different gestational periods that can be as low as 22 weeks.

In the UK, a stillbirth is defined as a baby being born dead after 24 weeks of pregnancy or later. Loss of a baby before that time is listed as a miscarriage.

Dr Lucy Smith, from the University of Leicester, who led the research published in The Lancet medical journal, said: “There are major and serious gaps in our knowledge of the burden of stillbirth which will have significant unforeseen impacts on families.

“To a mother or father, a second trimester stillbirth is no less tragic than a stillbirth at 28 weeks of pregnancy or later. These parents also deserve recognition of their loss and accurate reporting of their child’s death to improve care and policy.”

The researchers looked at data on pregnancy outcomes from 22 weeks of gestation from 19 European countries.

They found that in 2015, a total of 2.5 million births resulted in more than 9,300 babies being stillborn. Of these, a third were stillborn between 22 and 28 weeks of pregnancy and would have been excluded from reports following WHO’s recommendations for global data collection.

Rates of stillbirth from 22 to less than 24 weeks gestation varied six-fold between the countries included in the study.

Dr Smith said: “Wide variation in the number of stillbirths occurring between 22 weeks and 24 weeks is likely to highlight differences in the collection of data across European countries rather than variation in underlying stillbirth risk.”

One in every 200 babies in England is stillborn, according to the NHS.