Stillbirth risk by fetal size among 126.5 million births in 15 countries from 2000 to 2020: A fetuses‐at‐risk approach

• DOI: 10.1111/1471-0528.17890
• Publication Date: 2024-07-12T02:57:20Z
• Authors: Yemisrach B. Okwa...; Lorena Suárez‐Idueta; Eric O. Ohuma; Ellen Bradley; Judith Yargawa; Veronica Pingray; Gabriela Cormick; Adrienne Gordon; Vicki Flenady; Erzsébet Horváth‐...; Henrik Toft Sørensen; Liili Abuladze; Mohammed Heidarzadeh; Narjes Khalili; Khalid A. Yunis; Ayah Al Bizri; Arturo Barranco; Aimée E. van Dijk; Lisa Broeders; Fawzya Alyafei; Tawa O. Olukade; Neda Razaz; Jonas Söderling; Lucy K. Smith; Ruth J. Matthews; Rachael Wood; Kirsten Monteath; Isabel Pereyra; Gabriella Pravia; Sarka Lisonkova; Qi Wen; Joy E. Lawn; Hannah Blencowe
• Keywords: Live birth

Abstract Objective To compare stillbirth rates and risks for small gestational age (SGA), large (LGA) appropriate (AGA) pregnancies at 24–44 completed weeks of gestation using a birth‐based fetuses‐at‐risk approachs. Design Population‐based, multi‐country study. Setting National data systems in 15 high‐ middle‐income countries. Population Live births stillbirths. Methods A total 151 country‐years data, including 126 543 070 across countries from 2000 to 2020, were compiled. Births categorised into SGA, AGA LGA INTERGROWTH‐21st standards. Gestation‐specific rates, with as the denominator, gestation‐specific risks, fetuses still utero calculated 24 44 gestation. Main Outcome Measures according size birth. Results The overall rate was 4.22 per 1000 (95% CI 4.22–4.23) all gestations. Applying approach, highest gestation, 621.6 620.9–622.2) SGA pregnancies, 298.4 298.1–298.7) 338.5 337.9–339.0) pregnancies. risk (1.3–1.4 risk) prior 29 remained stable between 30 34 then increased gradually 35 8.4 8.3–8.4) ≥42 ratio (RR) consistently high compared RR observed (RR 9.2, 95% 15.2–13.2), lowest 3.1, 1.9–4.3). also countries, national variability ranging 0.70 0.43–0.97) Mexico 8.6 8.1–9.1) Uruguay. No observed. Conclusions Small (SGA) strongly associated this study based on high‐quality RRs seen preterm gestations, two‐thirds stillbirths born births. advance our understanding stillbirth, further analyses should be conducted sets low‐income settings, particularly those relatively SGA.