Clarity and consistency in stillbirth reporting in Europe: why is it so hard to get this right?

Mika Gissler*, Melanie Durox, Lucy Smith, Beatrice Blondel, Lisa Broeders, Ashna Hindori-Mohangoo, Karen Kearns, Rumyana Kolarova, Marzia Loghi, Urelija Rodin, Katarzyna Szamotulska, Petr Velebil, Guy Weber, Oscar Zurriaga, Jennifer Zeitlin, Gerald Haidinger, Jeannette Klimont, Sophie Alexander, Gisèle Vandervelpen, Wei Hong ZhangEvelin Yordanova, Rumyana Kolarova, Boris Filipovic-Grcic, Zeljka Drausnik, Urelija Rodin, Theopisti Kyprianou, Vasos Scoutellas, Petr Velebil, Laust Mortensen, Luule Sakkeus, Mika Gissler, Anna Heino, Beatrice Blondel, Anne Chantry, Catherine Deneux Tharaux, Guenther Heller, Nicholas Lack, Aris Antsaklis, István Berbik, Helga Sól Ólafsdóttir, Karen Kearns, Izabela Sikora, Marina Cuttini, Marzia Loghi, Cristina Tamburini, Serena Donati, Janis Misins, Irisa Zile, Jelena Isakova, Audrey Billy, Sophie Couffignal, Aline Lecomte, Guy Weber, Miriam Gatt, Peter Achterberg, Lisa Broeders, Ashna Hindori-Mohangoo, Jan Nijhuis, Rupali Akerkar, Kari Klungsøyr, Ewa Mierzejewska, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Vlad Tica, Jan Cap, Natasa Tul, Ivan Verdenik, Francisco Bolumar, Mireia Jane, Adela Recio Alcaide, Maria Jose Vidal, Oscar Zurriaga, Karin Källen, Anastasia Nyman, Sylvan Berrut, Melanie Riggenbach, Tonia A. Rihs, Alison MacFarlane, Lucy Smith, Rachael Wood, Jennifer Zeitlin, Melanie Durox, Marie Delnord, Alice Hocquette

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)


Background: Stillbirth is a major public health problem, but measurement remains a challenge even in high-income countries. We compared routine stillbirth statistics in Europe reported by Eurostat with data from the Euro-Peristat research network. Methods: We used data on stillbirths in 2015 from both sources for 31 European countries. Stillbirth rates per 1000 total births were analyzed by gestational age (GA) and birthweight groups. Information on termination of pregnancy at ≥22 weeks' GA was analyzed separately. Results: Routinely collected stillbirth rates were higher than those reported by the research network. For stillbirths with a birthweight ≥500 g, the difference between the mean rates of the countries for Eurostat and Euro-Peristat data was 22% [4.4/1000, versus 3.5/1000, mean difference 0.9 with 95% confidence interval (CI) 0.8-1.0]. When using a birthweight threshold of 1000 g, this difference was smaller, 12% (2.9/1000, versus 2.5/1000, mean difference 0.4 with 95% CI 0.3-0.5), but substantial differences remained for individual countries. In Euro-Peristat, missing data on birthweight ranged from 0% to 29% (average 5.0%) and were higher than missing data for GA (0-23%, average 1.8%). Conclusions: Routine stillbirth data for European countries in international databases are not comparable and should not be used for benchmarking or surveillance without careful verification with other sources. Recommendations for improvement include using a cut-off based on GA, excluding late terminations of pregnancy and linking multiple sources to improve the quality of national databases.

Original languageEnglish
Pages (from-to)200-206
Number of pages7
JournalEuropean Journal of Public Health
Issue number2
Publication statusPublished - 1 Apr 2022


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