{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T21:22:59Z","timestamp":1787779379952,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"S8","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"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","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 compare stillbirth rates and risks for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) pregnancies at 24\u201344 completed weeks of gestation using a birth\u2010based and fetuses\u2010at\u2010risk approachs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population\u2010based, multi\u2010country study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National data systems in 15 high\u2010 and middle\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Live births and stillbirths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 151 country\u2010years of data, including 126\u2009543\u2009070 births across 15 countries from 2000 to 2020, were compiled. Births were categorised into SGA, AGA and LGA using INTERGROWTH\u201021st standards. Gestation\u2010specific stillbirth rates, with total births as the denominator, and gestation\u2010specific stillbirth risks, with fetuses still in\u2009utero as the denominator, were calculated from 24 to 44\u2009weeks of gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Gestation\u2010specific stillbirth rates and risks according to size at birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall stillbirth rate was 4.22 per 1000 total births (95%\u2009CI 4.22\u20134.23) across all gestations. Applying the birth\u2010based approach, the stillbirth rates were highest at 24\u2009weeks of gestation, with 621.6 per 1000 total births (95%\u2009CI 620.9\u2013622.2) for SGA pregnancies, 298.4 per 1000 total births (95%\u2009CI 298.1\u2013298.7) for AGA pregnancies and 338.5 per 1000 total births (95%\u2009CI 337.9\u2013339.0) for LGA pregnancies. Applying the fetuses\u2010at\u2010risk approach, the gestation\u2010specific stillbirth risk was highest for SGA pregnancies (1.3\u20131.4 per 1000 fetuses at risk) prior to 29\u2009weeks of gestation. The risk remained stable between 30 and 34\u2009weeks of gestation, and then increased gradually from 35\u2009weeks of gestation to the highest rate of 8.4 per 1000 fetuses at risk (95%\u2009CI 8.3\u20138.4) at \u226542\u2009weeks of gestation. The stillbirth risk ratio (RR) was consistently high for SGA compared with AGA pregnancies, with the highest RR observed at \u226542\u2009weeks of gestation (RR\u20099.2, 95%\u2009CI 15.2\u201313.2), and with the lowest RR observed at 24\u2009weeks of gestation (RR\u20093.1, 95%\u2009CI 1.9\u20134.3). The stillbirth RR was also consistently high for SGA compared with AGA pregnancies across all countries, with national variability ranging from RR\u20090.70 (95%\u2009CI 0.43\u20130.97) in Mexico to RR\u20098.6 (95%\u2009CI 8.1\u20139.1) in Uruguay. No increased risk for LGA pregnancies was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Small for gestational age (SGA) was strongly associated with stillbirth risk in this study based on high\u2010quality data from high\u2010 and middle\u2010income countries. The highest RRs were seen in preterm gestations, with two\u2010thirds of the stillbirths born as preterm births. To advance our understanding of stillbirth, further analyses should be conducted using high\u2010quality data sets from low\u2010income settings, particularly those with relatively high rates of SGA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17890","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T22:57:20Z","timestamp":1720738640000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stillbirth risk by fetal size among 126.5 million births in 15 countries from 2000 to 2020: A fetuses\u2010at\u2010risk approach"],"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 and Child Health (MARCH) Centre London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Su\u00e1rez\u2010Idueta","sequence":"additional","affiliation":[{"name":"Mexican Society of Public Health  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric O.","family":"Ohuma","sequence":"additional","affiliation":[{"name":"Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Bradley","sequence":"additional","affiliation":[{"name":"Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Yargawa","sequence":"additional","affiliation":[{"name":"Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-2825","authenticated-orcid":false,"given":"Veronica","family":"Pingray","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy Ciudad Aut\u00f3noma de Buenos Aires  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Cormick","sequence":"additional","affiliation":[{"name":"Institute for Clinical Effectiveness and Health Policy Ciudad Aut\u00f3noma de Buenos Aires  Buenos Aires Argentina"},{"name":"Universidad Nacional de la Matanza  San Justo, Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Gordon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Flenady","sequence":"additional","affiliation":[{"name":"Centre of Research Excellence in Stillbirth, Mater Research Institute The University of Queensland (MRI\u2010UQ)  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzs\u00e9bet","family":"Horv\u00e1th\u2010Puh\u00f3","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liili","family":"Abuladze","sequence":"additional","affiliation":[{"name":"Estonian Institute for Population Studies, 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Population Health Sciences, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth J.","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Wood","sequence":"additional","affiliation":[{"name":"Public Health Scotland  Edinburgh UK"},{"name":"Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Monteath","sequence":"additional","affiliation":[{"name":"Pregnancy, Birth and Child Health Team Public Health Scotland  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Pereyra","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Catholic University of Maule  Talca 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