SynthesisBMC medicine2014
Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births.
Synthesis in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
86 citing papers in PubMed, 3 syntheses or guidelines pooled it, 183 citations in OpenAlex.
- The influence of fetal sex on maternal blood pressure in pregnancy.BMC medicine · 2025Pooled it
- Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis.Scientific reports · 2023Pooled it
- Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.BMC public health · 2020Pooled it
- Infant sex modifies associations between placental malaria and risk of malaria in infancy.Malaria journal · 2020Trial
- Trial
- Causes and risk factors for singleton stillbirth in Japan: Analysis of a nationwide perinatal database, 2013-2014.Scientific reports · 2018Trial
- Understanding stillbirths and maternal deaths in Pakistan: evidence from a national household survey.Journal of global health · 2026Article
- Incidence and risk factors for stillbirth in Kenya, Mozambique and the Gambia: the PRECISE cohort study.The Lancet regional health. Africa · 2026Article
- Fetal sex shapes placental inflammatory responses to extracellular mitochondrial DNA.bioRxiv : the preprint server for biology · 2026Article
- Donor age and sex program MSC secretome signaling: a quadrant framework for precision therapy.Stem cell research & therapy · 2026Article
- Stillbirths in a large Shanghai maternity centre (2014-2024): trends, sex distribution, and gestational age-specific risk.BMC pregnancy and childbirth · 2026Article
- Free Fetal Haemoglobin in Severe Early-Onset Fetal Growth Restriction: A Prospective Multi-Centre Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Machine learning analysis of pregnancy-related factors and stillbirth: a retrospective cohort study of 65,000 pregnant women in Shuyang, Suqian, Jiangsu, China, 2019-2024.BMC pregnancy and childbirth · 2026Article
- Article
- Article
- Article
- Effect of cryopreservation duration on pregnancy outcomes in embryos: a systematic review and meta-analysis.Human reproduction open · 2026Review
- Longitudinal modelling of growth in neonates exposed to antenatal steroids to quantify associations with final height: a cohort study.Archives of disease in childhood · 2025Observational
- Stillbirth burden and associated factors in Chengdu, Western China: a population-based retrospective study, 2019-2024.BMC pregnancy and childbirth · 2025Article
- Prevalence and factors associated with stillbirth in mothers delivered by cesarean section at Orotta National Referral Maternity Hospital: case-control study.BMC pregnancy and childbirth · 2025Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStillbirth rates have changed little over the last decade, and a high proportion of cases are unexplained. This meta-analysis examined whether there are inequalities in stillbirth risks according to sex.
methodsA systematic review of the literature was conducted, and data were obtained on more than 30 million birth outcomes reported in observational studies. The pooled relative risk of stillbirth was estimated using random-effects models.
resultsThe crude mean rate (stillbirths/1,000 total births) was 6.23 for males and 5.74 for females. The pooled relative risk was 1.10 (95% confidence interval (CI): 1.07-1.13). The attributable fraction in the whole population was 4.2% (95% CI: 3.70-4.63), and the attributable fraction among male fetuses was 7.8% (95% CI: 7.0-8.66). Study populations from countries with known sex-biased sex selection issues had anomalous stillbirth sex ratios and higher overall stillbirth risks than other countries, reflecting increased mortality among females.
conclusionsRisk of stillbirth in males is elevated by about 10%. The population-attributable risk is comparable to smoking and equates to approximately 100,000 stillbirths per year globally. The pattern is consistent across countries of varying incomes. Given current difficulties in reducing stillbirth rates, work to understand the causes of excess male risk is warranted. We recommend that stillbirths are routinely recorded by sex. This will also assist in exposing prenatal sex selection as elevated or equal risks of stillbirth in females would be readily apparent and could therefore be used to trigger investigation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.