{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:58:39Z","timestamp":1787774319833,"version":"build-2784847793"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess stillbirth mortality by Robson ten\u2010group classification and the usefulness of this approach for understanding trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Prospectively collected perinatal e\u2010registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All women aged 13\u201349\u2009years who gave birth to a live or stillborn baby weighting &gt;1000\u2009g between July 2021 and December 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared stillbirth risk by Robson ten\u2010group classification, and across countries, and calculated proportional contributions to mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Stillbirth mortality, defined as antepartum and intrapartum stillbirths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 80\u2009663 babies born to 78\u2009085 women; 3107 were stillborn. Stillbirth mortality by country were: 7.3% (Benin), 1.9% (Malawi), 1.6% (Tanzania) and 4.9% (Uganda). The largest contributor to stillbirths was Robson group\u200910 (preterm birth, 28.2%) followed by Robson group\u20093 (multipara with cephalic term singleton in spontaneous labour, 25.0%). The risk of dying was highest in births complicated by malpresentations, such as nullipara breech (11.0%), multipara breech (16.7%) and transverse\/oblique lie (17.9%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings indicate that group\u200910 (preterm birth) and group\u20093 (multipara with cephalic term singleton in spontaneous labour) each contribute to a quarter of stillbirth mortality. High mortality risk was observed in births complicated by malpresentation, such as transverse lie or breech. The high mortality share of group 3 is unexpected, demanding case\u2010by\u2010case investigation. The high mortality rate observed for Robson groups\u20096\u201310 hints for a need to intensify actions to improve labour management, and the categorisation may support the regular review of labour progress.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17833","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T07:12:20Z","timestamp":1715325140000},"page":"1465-1474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Stillbirth mortality by Robson ten\u2010group classification system: A cross\u2010sectional registry of 80\u2009663 births from 16 hospital in sub\u2010Saharan Africa"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8066-7873","authenticated-orcid":false,"given":"Claudia","family":"Hanson","sequence":"first","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Disease Control London School of Hygiene and Tropical Medicine  London UK"},{"name":"Centre of Excellence for Women and Child Health Aga\u2010Khan University, East Africa  Nairobi &amp; Dar\u2010es\u2010Salaam Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi Sidney","family":"Annerstedt","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Del Rosario","family":"Alsina","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muzdalifat","family":"Abeid","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Women and Child Health Aga\u2010Khan University, East Africa  Nairobi &amp; Dar\u2010es\u2010Salaam Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein L.","family":"Kidanto","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Women and Child Health Aga\u2010Khan University, East Africa  Nairobi &amp; Dar\u2010es\u2010Salaam Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle M\u00f6lsted","family":"Alvesson","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea B.","family":"Pembe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Muhimbili University of Health and Allied Sciences  Dar Es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Waiswa","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Maternal Newborn and Child Health, Department of Health Policy Planning and Management School of Public Health, Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Paul","family":"Dossou","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Reproduction Humaine et en D\u00e9mographie (CERRHUD)  Cotonou Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Effie","family":"Chipeta","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Health Kamuzu University of Health Science  Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Straneo","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Benova","sequence":"additional","affiliation":[{"name":"Department of Public Health Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ALERT team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"UN Inter\u2010agency Group for Child Mortality Estimation.Never forgotten. 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