Stillbirths – Has COVID-19 led to an increase in the rate?
Last summer researchers from St George’s Hospital in London began a retrospective study of pregnancy outcomes at their hospital. They compared two periods: from 1 October 2019 to 31 January 2020 (pre-pandemic) and from 1 February 2020 to 14 June 2020 (pandemic). They found that in the pre-pandemic period there were 4 stillbirths (2 per 1000 births) while in the pandemic period there were 16 stillbirths (9 per 1000). Their findings were published in the Lancet in August 2020. This was clearly a very concerning increase and we commented on the findings in our blog in November 2020.
At the time, the lead author of the study, Professor Asma Khalil, said: “The COVID-19 pandemic has had a profound impact on healthcare systems around the world. Disruption to services, nationwide lockdowns, and fear of attending health care facilities mean that the adverse effects of COVID-19 are expected to have health consequences that extend beyond the deaths and disease caused by the virus itself.”
Official figures for births and deaths in 2020 will not be published by the ONS until February 2022. However, the ONS has now published provisional data on the number of stillbirths which occurred during 2020. These indicate that in 2019 there were 640,370 births in England and Wales and 2,522 stillbirths (0.39%). While in 2020 there were 615,557 births in England and Wales and 2,429 stillbirths (0.39%). At this stage, there does not therefore appear to have been an overall increase in the rate of stillbirths as a result of the pandemic.
The UK continues to have one of the highest stillbirth rates across high income countries. In 2015 MBBRACE published a report considering perinatal death rates in term, singleton, normally formed, antepartum stillbirths in England. The report demonstrated a huge variation in care and practices across the country. In November 2015 the Department of Health announced a new ambition to reduce the rates of stillbirth, neonatal and maternal deaths in England by 50% by 2030 and implemented a national policy entitled, “Saving Babies’ Lives” in an attempt to standardise maternity care across the country. While there remains a long way to go to meet the ambition of a 50% reduction, since 2016 there has been a reduction in stillbirths each year. While thankfully it appears there has been no significant increase in the rate of stillbirths during the pandemic, we have not seen this decrease in stillbirth rates which has been a trend over previous years.
The provisional data also does not include any figures for neonatal deaths (deaths occurring within 28 days of birth). These figures are unlikely to be available until the ONS publishes official figures in February 2022. They also do not include figures for injuries sustained during birth.
The main purpose of antenatal care is to prevent, identify and treat conditions that may threaten the health of the fetus/newborn and/or the mother. It is clear that during the pandemic there was significantly reduced access to and engagement with routine antenatal services and it is hard to see how this could not have impacted on maternal and neonatal care.
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If you, or someone you know, has suffered a stillbirth or has any concerns in respect of the birth of your child or a maternal injury or and would like further advice in relation to pursuing a legal claim or making a complaint then please get in touch with us.