Temporal Trends of Stillbirth in Brazil Disaggregated by Maternal and Gestational Age

Abstract

Objective: Stillbirth is a neglected problem that needs to be given a greater visibility, especially in developing countries. This study aimed to describe temporal trends of stillbirth rates disaggregated by maternal and gestational age. Materials and methods: This is an ecological study conducted in Brazil. Stillbirth rates and temporal trends were calculated using data from 2011-2021, considering variables such as gestational age (≥ 22 weeks) and maternal age (10-19, 20-34, and ≥ 35 years old). Stillbirth rates were presented per 1,000 births, and trends were assessed via autoregressive models. Results: There were 228,386 stillbirths in Brazil, corresponding to 1 event per 133 live births at ≥ 22 gestational weeks in singleton pregnancies. At ≥28 weeks, the average stillbirth rates were 139.46 per 1,000 births (28-31 weeks), 36.59 per 1,000 births (28-36 weeks), 6.07 per 1,000 births (28-41 weeks), and 5.94 per 1,000 births (28-42 weeks and more). Data disaggregation by maternal age showed that average stillbirth rates were 7.69 per 1,000 births (mothers aged 10-19 years), 6.90 per 1,000 births (mothers aged 20-34 years), and 10.34 per 1,000 births (mothers aged ≥ 35 years). The temporal trends showed statistically significant increase in stillbirth rates in almost all gestational age strata among adolescent mothers, but not among older women. Conclusion: Older women experienced the highest stillbirth rates in Brazil but with a clear declining trend. The upward stillbirth trends revealed among adolescent mothers suggest that the fetal death prevention must be prioritized in the Brazilian adolescent health policy agenda.