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dc.contributor.authorMondal, Debapriya
dc.contributor.authorGalloway, Tamara S.
dc.contributor.authorBailey, Trevor C.
dc.contributor.authorMathews, Fiona
dc.date.accessioned2015-06-04T09:03:55Z
dc.date.issued2014
dc.description.abstractBACKGROUND: Stillbirth 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. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: Risk 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.en_GB
dc.description.sponsorshipWellcome Trusten_GB
dc.identifier.citationVol. 12, article 220en_GB
dc.identifier.doi10.1186/s12916-014-0220-4
dc.identifier.grantnumberWT094535MAen_GB
dc.identifier.urihttp://hdl.handle.net/10871/17395
dc.language.isoenen_GB
dc.publisherBioMed Centralen_GB
dc.relation.urlhttp://dx.doi.org/10.1186/s12916-014-0220-4en_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/25428603en_GB
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_GB
dc.subjectGender medicineen_GB
dc.subjectPregnancyen_GB
dc.subjectBirthen_GB
dc.subjectFetal lossen_GB
dc.subjectSexen_GB
dc.titleElevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million birthsen_GB
dc.typeArticleen_GB
dc.date.available2015-06-04T09:03:55Z
dc.identifier.issn1741-7015)
exeter.place-of-publicationEngland
dc.descriptionOpen Access journalen_GB
dc.descriptionCopyright © 2014 Mondal et al.; licensee BioMed Central Ltd.en_GB
dc.identifier.journalBMC Medicineen_GB


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