Antenatal interventions for preventing stillbirth: An overview or cochrane systematic reviews

Background

Stillbirth remains a major public health concern globally. Antenatal interventions may reduce stillbirths and improve maternal and neonatal outcomes in settings with high rates of stillbirth. There are several key antenatal strategies that aim to prevent stillbirth including nutrition, and prevention and management of infections.

Objectives

This systematic review summarised the evidence from Cochrane systematic reviews on the effects of antenatal interventions for preventing stillbirth for low risk or unselected populations of women.

Conclusion

Forty-three  Cochrane reviews were identified that included interventions in pregnant women with the potential for preventing stillbirth. While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife‐led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. Possible benefits were also observed for insecticide‐treated anti‐malarial nets and community‐based intervention packages, whereas a reduced number of antenatal care visits were shown to be harmful. However, there was variation in the effectiveness of interventions across different settings, indicating the need to carefully understand the context in which these interventions were tested.

Further high‐quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth.

Research team: Erika Ota, Katharina da Silva Lopes, Philippa Middleton, Vicki Flenady, Windy MV Wariki. Obaidur Rahman, Ruoyan Tobe-Gai, Rintaro Mori.