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10-04-2013 | Legal medicine | Article

Spontaneous stillbirth rates not on the rise

Abstract

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medwireNews: Canadian researchers have found that an increase in stillbirth rates over the past decade is due primarily to higher numbers of pregnancy terminations for congenital anomalies, and is not related to changes in spontaneous stillbirth rates.

The study findings also suggest that pregnancy characteristics on the rise, such as higher maternal age, greater maternal weight before pregnancy, and multiple births have not played a significant role in increased stillbirth rates.

Analyzing the 461,083 live births and 3991 stillbirths registered in British Columbia between 2000 and 2010, the authors found that the overall stillbirth rate increased by 31% from 8.1 to 10.6 per 1000 births.

However, during this time period there was in fact a nonsignificant decrease in the rate of spontaneous stillbirths from 5.7 to 4.8 per 1000 births, they report in CMAJ.

The authors found that the change in overall rate of stillbirths was due to the rate of pregnancy terminations which rose from 2.4 per 1000 births in 2000-2002 to 5.7 per 1000 births in 2008-2010, a 133% increase. This was accompanied by a decrease in the prevalence of congenital anomalies in live-born infants from 5.2 to 4.8 per 100 live births over the same time period.

"Infant deaths and late fetal deaths due to serious congenital anomalies are increasingly being replaced by pregnancy terminations before 24 weeks' gestation following prenatal diagnosis," say KS Joseph (University of British Columbia, Vancouver) and colleagues.

The authors say their study highlights the need for data regarding stillbirths to be separated from those regarding terminations. In Canada, pregnancy terminations with a fetal weight of 500g and greater or after 20 weeks' gestation are registered as stillbirths.

Additionally, they call for changes to "archaic" birth registration systems in many countries that require parents' involvement in registering stillbirth with the state, which can cause psychosocial harm to women and their families.

"One solution to this procedural problem would have the onus for stillbirth registration (and disposal of the fetal remains) placed on the health care provider and health care system and not on the distressed parents," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter

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