Press release: Stillbirths - The invisible public health problem


Interventions

Well-known interventions for women and babies would also reduce stillbirths

“This Series shows that the way to address the problem of stillbirth is to strengthen existing maternal, newborn, and child health programs by focusing on key interventions, which often overlap with those interventions that benefit mothers and neonates,” says Gary L. Darmstadt, M.D., Director, Family Health Division, Global Health Program, Bill & Melinda Gates Foundation.

According to The Lancet’s Stillbirths Series, as many as 1.1 million stillbirths could be averted with universal coverage of the following interventions:

  • Comprehensive emergency obstetric care: 696,000
  • Syphilis detection and treatment: 136 000
  • Detection and management of fetal growth restriction: 107,000
  • Detection and management of hypertension during pregnancy: 57,000
  • Identification and induction for mothers with >41 weeks gestation: 52,000
  • Malaria prevention, including bednets and drugs: 35,000
  • Folic acid fortification before conception: 27,000
  • Detection and management of diabetes in pregnancy: 24,000

“An additional 1.6 million deaths of mothers and newborns could be averted if you add five additional interventions beyond stillbirth interventions, such as antenatal steroids and neonatal resuscitation,” says Professor Zulfiqar A. Bhutta, M.D., PhD, Chair, Department of Pediatrics and Child Health, The Aga Khan University, Pakistan. “This is all highly doable and would save 2.7 million lives -- a massive achievement.”

Such interventions could be provided to all women everywhere at an overall cost of US$10.9 billion per year, or $2.32 per person in the 68 highest burden countries, according to the economic analysis by The Series team.

“This would provide a triple return for every dollar invested since these interventions can prevent stillbirths as well as save mothers and newborns, ” explains Robert Pattinson, M.D. of South Africa’s Medical Research Council, one of the team who developed the analysis using the Lives Saved Tool modelling.

If all women gave birth in health facilities offering high-quality, comprehensive emergency obstetric care, almost 700,000 stillbirths, 170,000 maternal deaths and nearly 600,000 neonatal deaths could be averted.

“Ultimately, there’s a direct correlation between greatly increased coverage of these interventions and the numbers of deaths averted,” says Carole Presern of PMNCH.

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