Decline in Stillbirth Rates in United States Has Stalled

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WEDNESDAY, Nov. 16, 2022 — A decline in the stillbirth rate was evident from 1980 to 2005, but then increased and stabilized, according to a study published in the Dec. 1 issue of The Lancet Regional Health – Americas.

Cande V. Ananth, Ph.D., M.P.H., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues used the 1980 to 2020 U.S. vital records data of live births and stillbirths at ≥24 weeks of gestation in a sequential time-series analysis. Stillbirth rates were examined overall and among Black and White women. Temporal changes in trends were evaluated in an age-period-cohort analysis.

Of the 157,192,032 live births and 710,832 stillbirths identified between 1980 and 2020, the researchers found a decline in the stillbirth rates per 1,000 births from 10.6 in 1980 to 5.9 in 2020. The rates of stillbirth decreased from 92 to 5.0 per 1,000 births among White women and from 17.4 to 10.1 per 1,000 births among Black women (rate ratios, 0.54 and 0.57, respectively). Compared with White women, Black women experienced persistent twofold higher rates of stillbirth (rate ratio, 2.01 in 2020). The rates of stillbirth declined until 2005, increased from 2005 to the mid-2010s, and then plateaued.

“The major reduction in stillbirth rates with subsequent stagnation since 2005 raises alarm about the current state of reproductive health in the United States,” the authors write. “Further, failure to close the racial disparity in stillbirths underscores the urgent public health needs to address persistent racial disparities through targeted preventative policies.”

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