Stillbirth rates in the United States plateaued between 2006 and 2012 at 6.05 stillbirths per 1,000 deliveries, reported Marian F. MacDorman, Ph.D., of the Maryland Population Research Center, University of Maryland, College Park, and colleagues.
The study was published online Nov. 9 in Obstetrics and Gynecology.
National Center for Health Statistics data (totaling 50,045 stillbirths and 8,268,441 live births) were employed to evaluate rates of fetal death and live birth in the 2006 and 2012 delivery cohorts. Age-specific stillbirth rates were calculated at 20 weeks’ of gestation or greater. Changes in rates of stillbirths and live births along with changes in percentage distribution among cohorts (segmented by gestational period duration) were assessed. Although only minimal changes were evident in the percent distribution of stillbirths by gestational age from 2006 to 2012, the percent distribution of live births by gestational age demonstrated considerable variation: births at 34-36 weeks’ gestation decreased by 12% from 2006 to 2012, by 10% at 37 weeks, and by 16% at 38 weeks. Conversely, births at 39 weeks’ gestation increased by 17% (Obstet Gynecol. 2015;126:1146-50).
As the aforementioned data reflect, there is broad support among clinicians for reducing nonmedically indicated deliveries before 39 weeks’ of gestation, but critics have suggested that longer pregnancies might lead to increased stillbirth incidence. However, “the lack of change in the prospective stillbirth rate from 2006 to 2012 suggests that preventing nonmedically indicated deliveries before 39 weeks’ of gestation did not increase the stillbirth rate at the national level,” Dr. MacDorman and associates said.
The research team characterized the lack of improvement in U.S. stillbirth outcomes from 2006 to 2012 as “disappointing.” To effectively decrease the stillbirth rate in a statistically significant manner, investigators suggested more concentrated research focused on better targeting of women in the early stages of pregnancy who are at the highest risk for stillbirth, to facilitate more careful monitoring and necessary interventions.
Dr. MacDorman and colleagues did not report any conflicts of interest.