PHM-Exch> 2.6 million babies stillborn in 2009. New global and country estimates published in Lancet Series

[Claudio Schuftan]

From: shila kaur <kaur_shila at yahoo.com>
*
                                                             News release
WHO/5*

*
                                                                12 April
2011   *

*2.6 million babies stillborn in 2009*

*New global and country estimates published in Lancet Series*

*Geneva, 14 April 2011:* Some 2.6 million stillbirths occurred worldwide in
2009, according to the first comprehensive set of estimates published today
in a special series of* The Lancet* medical journal.

Every day more than 7 200 babies are stillborn ─ a death just when parents
expect to welcome a new life ─ and 98% of them occur in low- and
middle-income countries.  High-income countries are not immune, with one in
320 babies stillborn ─ a rate that has changed little in the past decade.

The new estimates show that the number of stillbirths worldwide has declined
by only 1.1% per year, from 3 million in 1995 to 2.6 million in 2009.  This
is even slower than reductions for both maternal and child mortality in the
same period.

The five main causes of stillbirth are childbirth complications, maternal
infections in pregnancy, maternal disorders (especially hypertension and
diabetes), fetal growth restriction and congenital abnormalities.

*When and where do stillbirths occur?*

Almost half of all stillbirths, 1.2 million, happen when the woman is in
labour.  These deaths are directly related to the lack of skilled care at
this critical time for mothers and babies.

Two-thirds happen in rural areas, where skilled birth attendants ─ in
particular midwives and physicians ─ are not always available for essential
care during childbirth and for obstetric emergencies, including caesarean
sections.

The stillbirth rate varies sharply by country, from the lowest rates of 2
per 1 000 births in Finland and Singapore and 2.2 per 1 000 births in
Denmark and Norway, to highs of 47 in Pakistan and 42 in Nigeria, 36 in
Bangladesh, and 34 in Djibouti and Senegal.  Rates also vary widely within
countries.  In India, for example, rates range from 20 to 66 per 1 000
births in different states.

It is estimated that 66% ─ some 1.8 million stillbirths ─ occur in just 10
countries: India, Pakistan, Nigeria, China, Bangladesh, Democratic Republic
of the Congo, Ethiopia, Indonesia, Afghanistan and the United Republic of
Tanzania.

Comparing stillbirth rates in 1995 to 2009, the least progress has been seen
in Sub-Saharan Africa and Oceania.  However, some large countries have made
progress, such as China, Bangladesh, and India, with a combined estimate of
400 000 fewer stillbirths in 2009 than in 1995.  Mexico has halved its rate
of stillbirths in that time.

“Many stillbirths are invisible because they go unrecorded, and are not seen
as a major public health problem.  Yet, it is a heartbreaking loss for women
and families.  We need to acknowledge these losses and do everything we can
to prevent them.  Stillbirths need to be part of the maternal, newborn and
child health agenda,” says Dr Flavia Bustreo, WHO's Assistant
Director-General for Family and Community Health.

*Well-known interventions for women and babies would save stillbirths too*

The* Series* shows that the way to address the problem of stillbirth is to
strengthen existing maternal, newborn, and child health programmes by
focusing on key interventions, which also have benefits for mothers and
newborns.

According to an analysis to which WHO contributed in* The Lancet Stillbirth
Series*, as many as 1.1 million stillbirths could be averted with universal
coverage of the following interventions:

   - Comprehensive emergency obstetric care
           696 000
   - Syphilis detection and treatment
                           136 000
   - Detection and management of fetal growth restriction
           107 000
   - Detection and management of hypertension during pregnancy
   57 000
   - Identification and induction for mothers with >41 weeks gestation
           52 000
   - Malaria prevention, including bednets and drugs
           35 000
   - Folic acid fortification before conception
                   27 000
   - Detection and management of diabetes in pregnancy
           24 000

Strengthening family planning services would also save lives by reducing the
numbers of unintended pregnancies, especially among high-risk women, and
thereby reduce stillbirths.

“If every woman had access to a skilled birth attendant ─ a midwife, and if
necessary a physician ─ for both essential care and for procedures such as
emergency caesarean sections, we would see a dramatic decrease in the number
of stillbirths,” says Dr Carole Presern, Director of The Partnership for
Maternal, Newborn & Child Health (PMNCH), and a trained midwife.

*Stillbirths overlooked*

Despite the large numbers, stillbirths have been relatively overlooked. They
are not included in the Millennium Development Goals for improving maternal
health and reducing child mortality.

The estimates were generated using a statistical model that took records of
births and deaths (known as 'vital registration' data) from 79 countries,
surveys from 39 countries, and studies from 42 countries.  Weak vital
registration systems, especially in the regions where most stillbirths
occur, limit the availability of data and hamper the calculation of precise
estimates.  Vital registration systems must be improved so that all
stillbirths are counted.

The new estimates aim to improve knowledge about the extent of the problem,
and draw public and professional attention to stillbirths as a significant
global public health issue.

Some 69 authors from more than 50 organizations in 18 countries wrote the
six scientific papers, two research articles, and eight linked commentaries
included in* The Lancet Stillbirth Series*, which was initiated by the World
Health Organization ( WHO) and the Norwegian Institute of Public Health.

*UN commitment*

In September 2010, UN Secretary-General Ban Ki-moon announced the Global
Strategy for Women’s and Children’s Health, aimed at saving 16 million women
and children over the next five years.  In the framework of the Strategy,
numerous countries have committed to improving access to family planning,
antenatal care and skilled birth attendants, which should lead to reductions
in stillbirths.

In September this year, a special session on noncommunicable diseases (NCDs)
will be held at the UN General Assembly.  NCDs such as diabetes and
hypertension (high blood pressure) are risk factors for stillbirth.

*For further information***

Embargoed materials (press release, map, b-roll, etc) are available from
this password-protected web site: *
http://www.who.int/reproductivehealth/topics/maternal_perinatal/stillbirth/*<http://www.who.int/reproductivehealth/topics/maternal_perinatal/stillbirth/>

Username: StillbirthEstimates
Password: 50%by2020

To arrange interviews, please contact:

Olivia Lawe-Davies, Department of Maternal, Newborn, Child and Adolescent
Health, WHO
Email: *lawedavieso at who.int* <lawedavieso at who.int>; Office: + 41 22 791
1209; Mobile: +41 79 475 5545

Tammy Farrell, Partnership for Maternal, Newborn & Child Health (PMNCH)
Email: *farrellt at who.int* <farrellt at who.int>; Office: + 41 22 791 4711

All WHO information can be found at *www.who.int*
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