Observational studyEuropean journal of public health2019
Secular trends in stillbirth by maternal socioeconomic status in Spain 2007-15: a population-based study of 4 million births.
Observational study in European journal of public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Human Development Index of the maternal country of origin and its relationship with maternal near miss: A systematic review of the literature.BMC pregnancy and childbirth · 2020Pooled it
- Socio-Economic Inequalities in Stillbirth and Preterm Birth Rates Across Europe: A Population-Based Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Ultimate Context of the Termination of Parental Investment.International journal of environmental research and public health · 2025Review
- Using routine data to examine factors associated with stillbirth in three tertiary maternity facilities in Kabul, Afghanistan.Reproductive health · 2025Article
- Preterm birth and stillbirth rates associated with socioeconomic disparities during COVID-19 pandemic: a population-based cross-sectional study.BMJ paediatrics open · 2023Article
- Risk of Stillbirth Among Foreign-Born Mothers in the United States.Journal of immigrant and minority health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain.
methodsWe developed a population-based observational study, including 4 083 919 births during 2007-15. We estimate stillbirth rates and secular trends by maternal SES. We also evaluated the joint effect of maternal educational attainment and the Human Development Index (HDI) of women's country of origin on the risk of stillbirth. The data and statistical analysis can be accessed for reproducibility in a GitHub repository: https://github.com/migariane/Stillbirth.
resultsWe found a consistent pattern of socioeconomic inequalities in the risk of delivering a stillborn, mainly characterized by a persistently higher risk, over time, among women with lower SES. Overall, women from countries with low HDIs and low educational attainments had approximately a four times higher risk of stillbirth (RR: 4.44; 95%CI: 3.71-5.32). Furthermore, we found a paradoxical reduction of the stillbirth gap over time between the highest and the lowest SESs, which is mostly due to the significant and increasing trend of stillbirth risk among highly educated women of advanced maternal age.
conclusionOur findings highlight no improvement in stillbirth rates among women of lower SES and an increasing trend among highly educated women of advanced maternal age over recent years. Public health policies developing preventive programmes to reduce stillbirth rates among women with lower SES are needed as well as the necessity of further study to understand the growing trend of age-related stillbirths among highly educated women in Spain.
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