Examining the Changing Relationship between Stillbirth and Early Neonatal Mortality

Payal Hathi, University of California, Berkeley

Data on stillbirth is not routinely collected in many low and middle-income countries (LMICs) resulting in the neglect of stillbirth as an important component of the measurement of population mortality and health. In recognition of this fact, in 2006, the World Health Organization recommended using a ratio of 1.2 to estimate a country’s unknown stillbirth rate (SBR) from its known rate of early neonatal mortality (ENMR). This analysis uses Demographic and Health Survey data for 49 LMICs and UN Demographic Yearbook data for 20 high-income countries (HICs) to examine the relationship between stillbirth and early neonatal mortality globally. In recent decades, ratios of stillbirth to early neonatal mortality (SBR:ENMR) in HICs are consistently increasing to greater than 1.2 and even greater than 2.0 in many cases. In contrast, SBR:ENMR ratios in LMICs remain very low, largely below 1.0, a likely reflection of widespread stillbirth underreporting. These patterns suggest that the burden of stillbirth in LMICs may be greater than we know from existing estimates. Although data quality concerns remain, particularly for stillbirth, more attention to its prevalence and measurement are essential for gaining an accurate understanding of population health and wellbeing.

Keywords: Mortality and Longevity, Health and Morbidity, Data and Methods, Sexual and Reproductive Health and Rights

See extended abstract.