A review of stillbirth definitions: A rationale for change

Study shows that with improving survival rates for periviable infants, the stillbirth definition in Ireland should be reviewed to include to ?22 weeks’ gestation and ?400?g in line with improved medical developments.

Kristin Kelly, Sarah Meaney, Sara Leitao, Keelin O'Donoghue
Journal Name
European Journal of Obstetrics, Gynecology, and Reproductive Biology (EJOG)
Journal Article
Full Citation
Kelly K, Meaney S, Leitao S, O’Donoghue K. A review of stillbirth definitions: A rationale for change. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021;256:235-245.
Link to Publication


Stillbirth (infants born with no sign of life) definitions vary between countries. We explored stillbirth definitions in high income countries, as well as stillbirth and mortality rates and how these are influenced by resuscitation efforts for very premature infants. We included 33 publications in our review. Within the European Union, there was a large variation in the way countries classified stillbirths: some include infants born at gestational ages of 22 weeks while in others infants born at 24 weeks, or 28 weeks, and 180 gestational days are included. The median stillbirth rate in Europe increased from 2.7 per 1000 births (using a stillbirth classification of infants born at 28 weeks) to 3.3 per 1000 births (when stillbirths from 24 to 27 weeks gestation were included). Survival rates for infants born at 24 weeks gestation in Ireland almost doubled between 1995 and in 2014–2017 (56.6%). Survival rates of infants born at 23 weeks gestation (32.3 %) have also improved in 2014–2017. Multiple international organisations recommend recording stillbirths from 22 weeks gestation and/or 500g. We recommend the stillbirth definition in Ireland should be updated to 22 weeks’ gestation and 400g to comply with improved medical developments.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,