Understanding cause of stillbirth amongst high risk groups of mothers in England: A multi-dimensional approach

Understanding cause of stillbirth amongst high risk groups of mothers in England: A multi-dimensional approach

RJ Matthews, MSc, LK Smith, PhD, BN Manktelow PhD, ES Draper PhD

University of Leicester, UK

Background
In 2017, the English Government announced the commitment to halve the rate of stillbirths by 2025. To achieve this target, effective public health interventions aimed at reducing inequalities need to be based on a more detailed understanding of the differences in cause of death experienced by mothers from high risk groups. Differences in cause-specific stillbirth rates will be compared between groups of mothers using a multi-dimensional approach

Methods
Data on all singleton births (gestation 24+0 to 42+6 weeks) between January 2015 and December 2017 for mothers resident in England were obtained from MBRRACE-UK. Cause specific stillbirth rates are compared between groups of mothers defined on the basis of their age, ethnicity and socioeconomic deprivation.

Results
There were 6,943 stillbirths (3.8 per 1000 total births). Unexplained antepartum stillbirths were the most common cause of stillbirth (33.6%). 8.5% of stillbirths were caused by congenital anomalies, ranging from 6.8% in mothers living in areas with less deprivation to 14.5% in ethnic minorities living in most deprived areas. Placental causes of stillbirth were highest in younger mothers with most deprived income and education (36.6%) and lowest in less deprived older mothers (24.6%).

Conclusions
Examining national cause specific stillbirth allows the identification of groups of mothers and causes that can form the focus for future intervention strategies aimed at reducing mortality. Ethnic minority mothers living in most deprived areas have the highest rates of stillbirth, and higher numbers of congenital anomalies than other mothers.

Ethics statement:
MBRRACE-UK has s251 approval in England to collect data about stillbirths and neonatal deaths and use denominator data about all births without consent. For this analysis, conducted as part of the MBRRACE-UK programme, anonymised data were used.

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