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.