Researchers have identified key factors associated with stillbirth across Kenya, Mozambique and The Gambia, providing new evidence that could help improve pregnancy care and reduce preventable deaths.
Led by King’s College London, the London School of Hygiene & Tropical Medicine and Aga Khan University, the study analysed data from 5,772 women who received maternity care at seven health facilities between 2019 and 2022 through the PREgnancy Care Integrating translational Science, Everywhere (PRECISE) Network.
The PRECISE Network is an international collaboration investigating major complications of pregnancy, including hypertension, fetal growth restriction and stillbirth, with a focus on addressing inequalities in maternal and newborn health.
In the study, published in The Lancet Regional Health – Africa, the researchers found an overall stillbirth rate of 29.2 per 1,000 total births, with almost nine in 10 stillbirths occurring at 28 weeks of pregnancy or later. They also found that around one in 10 pregnancy losses occurred between 20 and 27 weeks’ gestation, highlighting losses that are often excluded from international reporting.
The study identified several factors associated with an increased risk of stillbirth, including previous stillbirth, severe high blood pressure during pregnancy, bleeding during pregnancy and babies who were not growing as expected in the womb.
The findings suggest that identifying these risk factors earlier could enable healthcare professionals to provide closer monitoring and timely treatment for women at greatest risk.
As an obstetrician, I understand the tragedy of stillbirth. What should have been a time of hope and joy is transformed into one of tragedy, isolation, and, in some societies, alienation. By identifying risk factors that precede these tragic events we provide opportunities for women and families, and the health systems designed to support them, to respond.
Professor Peter von Dadelszen, Professor of Global Women’s Health at King’s College London, Principal Investigator of the PRECISE Network, and co-senior author of the study.
Women who had previously experienced a stillbirth were found to be at particularly high risk of another stillbirth in a subsequent pregnancy. The researchers say these women may benefit from closer monitoring before and during pregnancy, particularly where underlying conditions such as hypertension, diabetes or malnutrition are present.
The findings also highlight the wider burden of stillbirth across Africa, which accounts for more than half of all stillbirths globally. The researchers hope the evidence will support earlier identification of women at risk and strengthen antenatal care across the region.
The PRECISE Network was funded by the UK Research and Innovation Grand Challenges Research Fund GROW Award scheme.
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Professor Peter von Dadelszen
Professor of Global Women’s Health
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