UK stillbirth rates among highest of rich nations

Stillbirth rates in the UK are higher than in almost every other high-income country, a series of reports suggest.

The UK had about 4,100 stillbirths in 2009 and, with a rate of 3.5 per 1,000 births, was ranked 33rd in a list of 193 countries - down from 26th in 1995.

Only France and Austria ranked lower among high-income nations.

The research, in The Lancet, also points to wide regional variations - stillbirths were a third more likely in the East Midlands than the South West.

According to the Lancet's figures, the 4,100 stillbirths in the UK in 2009 equates to about 11 children still born every day.

Although stillbirth rates are actually declining - by about 17.4% between 1995 and 2009 - other countries have moved faster, the report concludes.

Risk factors

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 cord 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 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."

'Healthy lifestyle'

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."

Judith Schott from the stillbirths charity, Sands, told the BBC there was a lack of awareness over stillbirths, which were 10 times more common than cot deaths.

"It's a very complex problem and what we do need is more research so that we can understand what is actually going on and hopefully pick up the women who are at risk that we now think aren't, and also monitor during pregnancy so we notice when babies are failing to thrive and do something about it, if possible, before they die," she said.

Pregnant women who notice any reduction in movement from the baby should go to the hospital to have themselves checked out, she added.

Health Minister Anne Milton said stillbirths were a major focus of research being carried out by the department's National Institute for Health Research in Cambridge.

"The death of a baby is devastating for parents and their families," she said.

"It is important that parents who have lost a baby receive the support and information they need. As well as information provided locally, the NHS Choices website gives information on stillbirth and signposts other sources of help."