Decrease in stillbirths in late pregnancy and older mums

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The number of stillbirths happening late in pregnancy has fallen, while the risk of mothers aged over 40 having a stillborn baby is also declining.

Experts attribute the fall in stillbirth rates among some groups of women to improvements in antenatal care, particularly for older mothers.

The positive news, contained in a report by the Australian Institute of Health and Welfare, comes despite the fact the overall rate of stillbirths across the country remained fairly stable from 1991 and 2009 between 6.4 and 7.8 in every 1000 births.

The report, 'Stillbirths in Australia 1991-2009', is the first national report examining the link between maternal, pregnancy and birth factors and stillbirth.

Figures show the the risk of stillbirth occurring between 28 and 41 weeks gestation fell between 1991 and 2009, however there was an increase in the risk of stillbirths between 20 and 27 weeks gestation.

Stillbirth rates in mothers aged 40 or older fell from 12.7 to 10.6 per 1000 births over the same time period.

Griffith University's Professor of Obstetrics and Gynaecology David Ellwood welcomed the findings, saying if the improvement is related to women receiving better antenatal care, there is the potential for the stillbirth rates for some groups of women to be reduced further.

"The reduced risk of stillbirth in pregnancies after 28 weeks of gestation is an important finding, as this is an age beyond which we would expect good outcomes for babies born alive," Professor Ellwood, who represents the Fetal Deaths Report Expert Reference Group, said.

"The drop in stillbirth rates over time for older women may suggest that some interventions introduced in recent years to the care of pregnant women in later pregnancy have been of benefit, and that further reductions in stillbirth may be possible, but further investigations are needed to determine best practice."

Stillbirth is defined as the birth of a baby who shows no signs of life after a pregnancy reaches least 20 weeks gestation or weighing 400 grams or more. Although the cause is often not known, congenital anomalies, or birth defects, are responsible for 21 percent of all stillbirths in Australia.

The report contained other positive news, with the rate of stillbirth among indigenous women falling from 15.5 per 1000 births from 1991 to 1994 to 12.3 per 1000 births from 2005 to 2009. However these rates are still higher than for non-indigenous mothers.

There was worrying news about the outcomes for teenage pregnancies: figures in the report show the rate of stillbirth among teenage mothers increased from from 9.5 to 15.0 per 1000 births between 1991 and 2009.