{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:21:31Z","timestamp":1781097691519,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"S8","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010409","name":"Children's Investment Fund Foundation","doi-asserted-by":"publisher","award":["1803\u201002535"],"award-info":[{"award-number":["1803\u201002535"]}],"id":[{"id":"10.13039\/100010409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the contribution of preterm birth and size\u2010for\u2010gestational age in stillbirths using six \u2018newborn types\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population\u2010based multi\u2010country analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Births collected through routine data systems in 13 countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>\n                      125\u2009419\u2009255 total births from 22\n                      <jats:sup>+0<\/jats:sup>\n                      to 44\n                      <jats:sup>+6<\/jats:sup>\n                      weeks\u2019 gestation identified from 2000 to 2020.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included 635\u2009107 stillbirths from 22\n                      <jats:sup>+0<\/jats:sup>\n                      \u2009weeks\u2019 gestation from 13 countries. We classified all births, including stillbirths, into six \u2018newborn types\u2019 based on gestational age information (preterm, PT, &lt;37\n                      <jats:sup>+0<\/jats:sup>\n                      \u2009weeks versus term, T, \u226537\n                      <jats:sup>+0<\/jats:sup>\n                      \u2009weeks) and size\u2010for\u2010gestational age defined as small (SGA, &lt;10th centile), appropriate (AGA, 10th\u201390th centiles) or large (LGA, &gt;90th centile) for gestational age, according to the international newborn size for gestational age and sex INTERGROWTH\u201021st standards.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Distribution of stillbirths, stillbirth rates and rate ratios according to six newborn types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      635\u2009107 (0.5%) of the 125\u2009419\u2009255 total births resulted in stillbirth after 22\n                      <jats:sup>+0<\/jats:sup>\n                      \u2009weeks. Most stillbirths (74.3%) were preterm. Around 21.2% were SGA types (PT\u2009+\u2009SGA [16.2%], PT\u2009+\u2009AGA [48.3%], T\u2009+\u2009SGA [5.0%]) and 14.1% were LGA types (PT\u2009+\u2009LGA [9.9%], T\u2009+\u2009LGA [4.2%]). The median rate ratio (RR) for stillbirth was highest in PT\u2009+\u2009SGA babies (RR 81.1, interquartile range [IQR], 68.8\u2013118.8) followed by PT\u2009+\u2009AGA (RR 25.0, IQR, 20.0\u201334.3), PT\u2009+\u2009LGA (RR 25.9, IQR, 13.8\u201328.7) and T\u2009+\u2009SGA (RR 5.6, IQR, 5.1\u20136.0) compared with T\u2009+\u2009AGA. Stillbirth rate ratios were similar for T\u2009+\u2009LGA versus T\u2009+\u2009AGA (RR 0.7, IQR, 0.7\u20131.1). At the population level, 25% of stillbirths were attributable to small\u2010for\u2010gestational\u2010age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In these high\u2010quality data from high\/middle income countries, almost three\u2010quarters of stillbirths were born preterm and a fifth small\u2010for\u2010gestational age, with the highest stillbirth rates associated with the coexistence of preterm and SGA. Further analyses are needed to better understand patterns of gestation\u2010specific risk in these populations, as well as patterns in lower\u2010income contexts, especially those with higher rates of intrapartum stillbirth and SGA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17653","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T03:29:05Z","timestamp":1701228545000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Stillbirths: Contribution of preterm birth and size\u2010for\u2010gestational age for 125.4\u2009million total births from nationwide records in 13 countries, 2000\u20132020"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-2856","authenticated-orcid":false,"given":"Yemisrach B.","family":"Okwaraji","sequence":"first","affiliation":[{"name":"Maternal, Adolescent, Reproductive &amp; Child Health (MARCH) Centre London School of Hygiene &amp; 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