Investigation of stillbirths in Brazil: A systematic scoping review of the causes and related reporting processes in the past decade

BackgroundRecognizing the causes of stillbirths and their associated conditions is essential to reduce its occurrence. ObjectiveTo describe information on stillbirths in Brazil during the past decade. Search strategyA literature search was performed from January 2010 to December 2020. Selection criteriaOriginal observational studies and clinical trials. Data collection and analysisData were manually extracted to a spreadsheet and descriptive analysis was performed. ResultsA total of 55 studies were included; 40 studies (72.2%) used the official data stored by national public health systems. Most articles aimed to estimate the rate and trends of stillbirth (60%) or their causes (55.4%). Among the 16 articles addressing the causes of death, 10 (62.5%) used the International Classification of Diseases; most of the articles only specified the main cause of death. Intrauterine hypoxia was the main cause reported (ranging from 14.3% to 54.9%). ConclusionHaving a national system based on compulsory notification of stillbirths may not be sufficient to provide quality information on occurrence and, especially, causes of death. Further improvements of the attribution and registration of causes of deaths and the implementation of educational actions for improving reporting systems are advisable. Finally, expanding the investigation of contributing factors associated with stillbirths would create an opportunity for further development of prevention strategies in low- and middle-income countries such as Brazil.

Automated summary

This study aims to describe the information on stillbirths in Brazil during the past decade. The results indicate that having a national system based on compulsory notification of stillbirths may not be sufficient to provide quality information on occurrence and causes of death. Therefore, further improvements in the attribution and registration of causes of deaths, as well as the implementation of educational actions to improve reporting systems, are advisable. Additionally, expanding the investigation of contributing factors associated with stillbirths would create an opportunity for the development of prevention strategies.