By Dr Ananya Mandal, MD
According to experts, excessive weight, smoking and late maternal age over 35 are contributing to thousands of stillbirths each year in high-income countries, including Australia, and the trend looks set to continue. These figures were published in the Lancet medical journal.
The report said that nearly 12 per cent or 8,000 stillbirths in high-income countries each year can be attributed to a mother's body mass index being more than 25 before conception. Mother’s age over 35 is also a major factor, causing about 11 per cent or 4,000 cases each year. Smoking was responsible for about six per cent or 3,000 stillbirths each year in high-income countries, the report said, with evidence mounting that passive smoking is also a risk factor for mothers. Among other risk factors are first-time birth and a previous caesarean, and many cases are caused by infections, umbilical cord abnormalities and accidents, medical disorders such as pre-eclampsia, high blood pressure and diabetes, and birth defects. The report reveals that suboptimal care was associated with up to 60 per cent of cases. This includes delayed recognition of problems and interventions that might have helped.
“It's a scandal there are so many stillbirths that can be prevented,” said Joy Lawn, director of global evidence and policy at Save the Children in South Africa, who led the Lancet series. She said the politics of public health has meant the stillbirths problem has been sidelined by maternal and child health programs, even though there are more stillbirths than children killed by AIDS and malaria combined. In developing countries, most stillbirths are caused by delivery complications, maternal infections in pregnancy, fetal growth problems and congenital abnormalities. In developed countries, the reasons are often unclear why stillbirths occur, and surveillance and autopsy data are patchy.
In the report on the high-income countries by Associate Professor Vicki Flenady from Brisbane's Mater Medical Research Institute among others, it appears that low socioeconomic status and ethnic origin also increased a woman's chance of stillbirth with indigenous Australians experiencing twice the risk of non-indigenous Australian women.