Management in Health, Vol 22, No 4 (2018)

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STILLBIRTHS IN EUROPE – SIGNIFICANT PUBLIC HEALTH PROBLEM

Gena G. GRANCHAROVA, Dima K. TSANOVA, Silviya S. ALEKSANDROVA-YANKULOVSKA

Abstract


BACKGROUND

Together with the achievements and efforts for further reduction of infant mortality and under-five-mortality the stillbirths remain a significant global public health problem.  In 2015 the estimated number of stillbirths is 2.6 million, e.g. 7178 deaths per day (WHO). Most of these deaths occur in developing countries, but the problem is important for Europe as well in the context of ageing population and low birth rate. 

The aim of this report is to analyse the trends in stillbirth rates in European region since 1990s to 2015.

METHODS

Primary data on stillbirths were extracted from European database “Health for all”. The countries were grouped by Gross National Income (GNI) per capita according to World Bank criteria relevant to 2018-2019. The means of stillbirths in different countries groups were compared and Pearson’s correlation coefficients with GNI and other variables were calculated. Data processing was performed by SPSS v.24.

RESULTS

Decreasing trend in stillbirths has been observed in parallel with the increase of GNI, significantly more expressed in high-income countries. The mean stillbirth rate in the seven countries with lower-middle income was 2.5 times higher as compared to the mean for 34 high-income countries. The discrepancy in the mean GNI for both groups is over 16 times. For 12 higher-middle income countries the mean stillbirth rate is 1.5 times higher compared to high-income countries, and GNI – 6 times lower. A moderate correlation of stillbirths with GNI has been found and it increases from r=-0,305 in 1970s to r=-0,420 for 2013-2015. Some increase in correlation of stillbirths with proportion of live births to mothers aged under 20 years has also been observed - from r=+0.215 to r=+0.532. 

CONCLUSION

Socio-economic development and decrease in early pregnancy are among the leading factors to further reduction of stillbirths in European region.

 

Keywords: Stillbirth, European region, public health, gross national income


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