ABSTRACT
Background: Inequities in stillbirth rate according to
ethnicity persist in high income nations.
Objectives: To investigate whether causes of stillbirth differ
by ethnicity in high-income nations.
Search strategy: Medline, Embase, Scopus, CINAHL, Cochrane
Library, and Global Health databases since their inception to 1 February
2021.
Selection criteria: Cohort, cross-sectional, and retrospective
studies investigating the causes of stillbirth in various ethnic groups.
Data collection and analysis: Systems of classification and
causes of stillbirth were aligned to the International Classification of
Disease 10 for Perinatal Mortality (ICD10-PM) and pooled estimates were
derived by meta-analysis.
Main results: Fifteen reports from 3 countries (72,555
stillbirths) were included. Seven ethnic groups – “Caucasian”
(n = 11 studies, n = 37,578 stillbirths), “African”
(n = 11 studies, n = 17,883 stillbirths), “Hispanic”
(n = 7 studies, n = 12,810 stillbirths), “Indigenous
Australian” (n = 4 studies, n = 1,117 stillbirths),
“Asian” (n = 2 studies, n = 15 stillbirths), “South
Asian” (n = 2 studies, n = 55 stillbirths), and
“American Indian” (n = 1 study, n = 27 stillbirths) –
were identified. There was an overall paucity of recent, high-quality
data for many ethnicities. For those with the greatest amount of data –
Caucasian, African, and Hispanic – no major differences in the causes
of stillbirth were identified.
Conclusion: There is a paucity of high-quality information on
causes of stillbirth for many ethnicities. Improving investigation and
standardising classification of stillbirths is needed to assess whether
causes of stillbirth differ across more diverse ethnic groups.
Funding: Nil
Key words: stillbirth, causes, ethnicity, inequity, public
health, obstetrics, pregnancy, foetal
Tweetable abstract: Data investigating ethnic variation in
causes of stillbirth is limited but our review does not suggest any
differences between ethnicities.