Many stillborn babies may have been forgotten | Life and style

According to research, hundreds of thousands of babies who died in the womb could have been excluded from international estimates of stillbirths.

According to 2015 figures, an estimated 2.6 million babies a year in the world are stillborn, dying at a time of pregnancy when most babies would survive out of the womb.

However, while the World Health Organization recommends that countries collect data on stillbirths from 22 weeks of pregnancy, only data of 28 weeks or more are used for international comparisons and estimates.

Studies published in the Lancet show that this threshold means that a large number of stillbirths that occur earlier in pregnancy are not recognized, European data revealing international estimates could be 50% higher, at least in high income. 22 weeks are included.

"This work was intended to highlight how many parental losses are not recognized by standard rates and to examine stillbirths early in pregnancy," said Dr. Lucy Smith, first author of the study at the University of Toronto. Leicester. "If we do not have data about them, we can not see how we can design interventions to reduce these stillbirths early, and they can have different causes of death or different patterns.

The study examined national data from 19 countries in Europe and interested in stillbirths at different gestational ages from 22 weeks between 2004 and 2015.

Stillbirth rates varied from country to country – especially before 24 weeks – and a handful of countries included late terminations in their data. Three of them, including England, did not have data on stillbirths before 24 weeks.

Nevertheless, the results reveal that in 2015 alone, more than 3 000 stillbirths occurred in Europe between 22 and 28 weeks of pregnancy, which represents, overall, 32% of all stillbirths at 22 weeks of age. or after.

The authors state that the gestational age used for international comparisons and estimates should be reduced to 24 weeks and that countries should better collect data from 22 weeks to allow researchers to better analyze trends.

Professor Joy Lawn of the London School of Hygiene and Tropical Medicine, who co-authored a comment, said global stillbirths could be 30 to 50 percent higher than current estimates.

"People have this idea that stillbirths are just meant to be and that they are happening quietly and that no one is counting them. [But] we can count them, we can compare and that's a huge number, "she said, adding that many stillbirths are preventable.

"Part of the problem with stillbirths, especially past mortalities, is that if we do not count them and ignore trends, people do not invest in their change."

But, she added, comparing the 22-week data could be difficult for low-income countries where babies are less likely to survive outside the uterus at an early gestational age and where the collection data is already difficult.

Separate research, also published in the Lancet, explored the possibility of reducing the stillbirth rate, based on fetal movement awareness – an approach that has shown promise in Norway.

"One in 200 pregnancies ends in stillbirth in the UK and [it’s] clearly devastating for absolutely everyone and the family, "said Professor Jane Norman, first author of the study at the University of Edinburgh.

The study, involving 33 hospitals and more than 400,000 pregnancies over a two-year period starting in January 2014, investigated the impact of encouraging women to know their baby's movements in the world. Uterus and to promptly report any changes. If necessary, deliveries at risk of stillbirth could be made, with advice given to clinicians.

However, after taking into account factors including the age of the mother, the researchers found that the program did not produce any significant reduction in the stillbirth rate at 22 weeks of gestation or later.

Given the high expectations initially, the researchers say the study was not meant to confidently demonstrate a small advantage, that everyone might not have joined the new program, and that women

The team said awareness and reporting of fetal movement reductions was still important – they are already part of NHS Saving Babies' Lives Care series.

But Lawn said the study suggests that health services need better monitoring of pregnancies.

"When a baby is in utero and he stops moving, you have probably already missed the event. The most important thing is increased monitoring during pregnancy, "she said, adding that it is important that women do not feel blamed or stigmatized for stillbirth.

But, she said, the drop in stillbirth rates suggests that improvements can still be made: "It's not" if it does not work, nothing works ".