Around 29% of still births are caused by placental problems, but around a third have no obvious cause A series of new reports in the The Lancet suggest stillbirth rates in the UK are higher than in almost every other high-income country.
Britain ranks only 33rd in a list of countries ranked by stillbirths per 1,000 births, down from 26th in 1995. Only France and Austria rank lower among high-income nations.
The research also points to wide regional variations in the UK, with stillbirths a third more likely in the East Midlands than in the South West.
According to The Lancet’s figures, approximately 4,100 stillbirths occurred in the UK in 2009, which equates to about 11 children still born every day.
Although stillbirth rates are actually declining – by about 3.5% between 2000 and 2009 – other countries have moved faster, the report concludes.
The causes of stillbirths in high-income countries are both manifold and often unclear.
An estimated 29% are caused by problems with the placenta, which can affect the growth of the foetus. Some 12% are linked with infections, 9% with umbilical chord problems and 6% with congenital abnormalities.
But 30% of stillbirths have no obvious cause.
There are also risk factors which can increase the risk of stillbirth. Smoking and drinking during pregnancy can increase susceptibility, as can being overweight or obese, or having children later in life. Previous caesarean sections can also increase risk, as can multiple births.
But the authors of the series stress a stillbirth can affect any woman, with or without risk factors.
They say better monitoring during pregnancy could reduce the figures, but say more research is needed to more clearly understand what causes a baby to be still born.
“The grief of a stillbirth is unlike any other form of grief,” said Dr Richard Horton, The Lancet’s editor-in-chief.
“Almost three million stillbirths happen worldwide every year, which, even for a country with a developed health system such as the UK, means that 11 sets of parents every day will take home their newborn baby in a coffin.”
The causes behind the regional variations seen in the UK are also unclear, but the researchers believe social deprivation could be playing at a part.
“Within the UK there’s about a 33% difference between the South West with the lowest rates and the East Midlands with the highest rates,” said Professor Gordon Smith of Cambridge University and a report author.
“Why we see that variation we don’t know, but there’s plausible explanations around deprivation and around different ethnic groups.”
Dr Tony Falconer, President of the Royal College of Obstetricians and Gynaecologists, welcomed the survey, and said the data provided further evidence of the link between stillbirth and maternal obesity.
“The rise in obesity is a serious issue and women need to be encouraged to lead a healthy lifestyle before conception to ensure the best outcome for them and their baby,” he said.
“Although we have good information about the social demographics of stillbirth, we need to know more about the pathology of stillbirth and more research in this area is needed.”
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