'National scandal' of 11 stillbirths a day means Britain has one of worst survival rates

By Jenny Hope for the Daily Mail
Updated: 06:37 EDT, 14 April 2011

• UK ranked 33rd in world league table on par with Belarus
  
• Women in Midlands most at risk of having stillbirths
  

Britain has one of the worst rates of stillborn babies in the western world, says an international audit.

More than 4,000 stillbirths occur each year - the equivalent of 11 a day - at a rate that has barely changed in a decade.

Britain's stillbirth rate puts it in a par with Belarus and Estonia, according to research

Experts estimate one in three stillbirths is linked to factors that are 'preventable' by the mother, such as obesity, giving birth at an older age and smoking during pregnancy.

In the UK, this adds up to 1,400 babies born dead each year after the first 24 weeks of pregnancy.

Yet many women and even some health professionals appear unaware of the extra risk posed by lifestyle factors, claim doctors.

At least one-third of stillbirths remain unexplained

A new audit shows the UK well down the league table of 193 nations, including some of the world's poorest countries, with a stillbirth rate of 3.5 per 1,000 births putting it in joint 33rd position.

Out of all the high-income countries, only New Zealand, Austria and France have higher stillbirth rates.

The UK's record puts it on a par with Belarus and Estonia, and well behind the best performer Finland at just two per 1,000 births, says the audit published in The Lancet medical journal (must credit).

The figure of 4,100 stillbirths a year is ten times higher than the annual toll of cot deaths, at around 300.

Among victims of stillbirth are Britain's Got Talent Judge Amanda Holden, who lost a baby boy when seven months' pregnant in February. She bravely said earlier this week that she and husband Chris Hughes would try again.

The new report says stillbirth had been an 'invisible' problem that is largely ignored, with too little effort going into investigations of individual tragedies or research into causes and prevention.

Common causes of stillbirth include congenital malformations, maternal medical problems and birth complications and infections. However, up to a third of cases cannot be explained.

Major 'lifestyle' risk factors for women include being over 35 years of age, carrying excess weight, smoking, alcohol or drug abuse, teenage pregnancy and multiple pregnancies, belonging to an ethnic minority group and social deprivation.

Experts said older women being more at risk during pregnancy could contribute to stillbirth rates

It is estimated that 705 stillbirths a year in the UK are linked to maternal obesity, 367 to older mothers and 346 associated with smoking in pregnancy - a total of 1,418. The audit could not put a figure on those linked to drinking during pregnancy.

Professor Gordon Smith, one of the authors from Cambridge University, said the stillbirth rate in the UK was higher than comparable countries for 'unexplainable' reasons, although key factors were obesity, smoking and maternal age.

However, he personally knew of a case where a woman in her 40s had a stillbirth yet neither she nor her midwife were aware of the extra risk.

He said 'Women are planning to have their pregnancies later in life.

'Realistically, what we can do is make sure everybody knows that these older women are at increased risk. 'The women themselves should know and the people looking after them should know.'

In higher risk cases, women should know of the importance of antenatal care and seeking help if the baby stops kicking in later pregnancy.

But, he added, 'it's easy to talk about greater awareness and very hard to do something about it' and women should not be blamed if they lost a baby as many such cases remained unexplained.

Dr Tony Falconer, president of the Royal Colege of Obstetricians and Gynaecologists, said older mothers were known to be at higher risk and those who were obese.

He said 'The rise in obesity is a serious issue and women need to be encouraged to lead a healthy lifestyle before conception to ensure the best outcome for them and their baby.'

Neal Long, chief executive of Sands, the stillbirth and neonatal death charity, said 'Eleven babies dying every day is a national scandal which has persisted for far too long in this country.

'This seemingly endless death toll of thousands of babies every year has the most terrible long-term impact on parents and their families.

'Many mums in the UK have increasingly complex pregnancies. This, coupled with already stretched maternity services, entering an era of budget cuts, could spell disaster for many more babies and their families.'