Page last updated at 23:12 GMT, Tuesday, 23 June 2009 00:12 UK

Stillbirths 'starting to fall'

Pregnant woman
Doctors still do not understand why some babies are stillborn

The proportion of babies born dead has fallen for the first time since 2000, an independent report has shown.

England, Wales and Northern Ireland are also seeing the lowest rate of babies dying in the first weeks of life since the turn of the century, Cemach found.

Older mothers had the highest risk of having a stillborn infant, while the babies of teenagers were the most likely to die in the first few weeks.

Experts warn the improvements must be repeated to signify a positive trend.

Campaigners also noted that the figures were simply now back where they had been in the late 1990s, suggesting there was "no room for complacency".

Starting at 5.4 per 1,000 live births in 2000, the stillbirth rate went up to 5.7 for several years before falling to 5.2 in 2007, the latest year in which figures have been collected.

While the stillbirth rate in multiple births remains high, it too has improved, falling from 16.7 per 1,000 births in 2000 to 12.2 in 2007.

The number of twin babies dying in the first few weeks of life - the neonatal mortality rate - has also improved, at the same time as the number of twins born as a result of fertility treatment increased.

Poverty and age

For the first time, researchers from the Confidential Enquiry into Maternal and Child Health (Cemach) also gathered some data from Scotland, where the stillbirth rate appears to be higher than for other parts of the UK.

This may be explained by discrepancies in collection, the report stressed, but also noted that the reasons for a large number of stillbirths remained unclear.

They did however suggest links with age, ethnicity and social deprivation.

The increasing number of older mothers is a trend which we will need to monitor closely since there are long-term consequences involved which impact on society and the NHS
Professor Sabaratnam Arulkumaran
Royal College of Obstetricians Gynaecologists

Women in the age group 30-34 years had the lowest risk of stillbirth and neonatal death.

Those aged 40 and above were found to have the highest risk of stillbirth, while those aged less than 20 years had the highest risk of neonatal death classified as a death before the baby had reached 28 days.

The babies of older women may be affected by their mothers' increase tendency to develop high blood pressure, a form of diabetes and placental abruption, when the placenta - which nourishes the baby - comes away from the womb. All of these are thought to contribute to stillbirth.

Ethnicity also seems to be an issue. In 2007, the stillbirth rates for women of black and Asian ethnicity were 2.7 times and two times higher respectively than that of white women.

The Cemach team reported that when it came to teenage mothers, nearly three quarters were classified as living in serious deprivation.

They also found that women who experienced either a stillbirth or neonatal death were less likely than other mothers to have registered their pregnancy with a doctor by 12 weeks - around 50% compared to 71% for all pregnant women.

No autopsy

While more postmortems were being offered in 2007 - an important method of clarifying why a baby might have died - an increasing number of parents were refusing the procedure.

Professor Sabaratnam Arulkumaran, president of the Royal College of Obstetricians Gynaecologists, said professionals "must remain vigilant over the common maternal risk factors and identify women who may require extra support.

The 2007 stillbirth rate still equates to over 4,000 babies stillborn every year - that's 11 babies dying every single day in the UK, or almost one in every 200 babies
Stillbirth charity Sands

"The increasing number of older mothers is a trend which we will need to monitor closely since there are long-term consequences involved which impact on society and the NHS."

Health Minister Ann Keen said the government would continue to work with the NHS to reduce rates further.

"For the best health outcomes, women should access maternity services at an early stage.

"This is why we say that all women should have their personal needs and risks assessed by a healthcare professional by the twelfth week of pregnancy," she added.

Sands, the stillbirth and neonatal death charity, warned the statistics "must be taken in context".

"The 2007 stillbirth rate still equates to over 4,000 babies stillborn every year - that's 11 babies dying every single day in the UK, or almost one in every 200 babies," a spokesman said.

The charity is calling for better monitoring during antenatal care, more midwives with greater resources to support them and more research to improve understanding of why so many so many babies are stillborn.



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