Stillbirths in Germany: on the rise, but no additional increases during the first COVID-19 lockdown

Kniffka, M. S., Nitsche, N., Rau, R., Kühn, M.
OSF preprints
12 pages.
originally posted on: 27 May 2021 (2021), unpublished
Open Access


A growing body of studies on the indirect effect of the COVID-19 pandemic on stillbirths shows mixed and context-dependent evidence, even within high-income countries. We examined possible changes in the stillbirth rate in Germany during the first COVID-19 lockdown.
We used population-level data on live and stillbirths occurring between January 1995 and July 2020 and applied negative binomial regression to estimate the yearly and monthly stillbirth rate in this period. We compared the actual stillbirth rate to the expected figure for the first seven months of 2020, based on prediction intervals derived from the detected time trend.
We detected a steady increase in stillbirths in Germany since 2013, which was preceded by a declining (1995-2004), and then plateauing (2005-2012) stillbirth rate. The stillbirth rate for January 2020 through July 2020 (4·148) was slightly lower than the stillbirth rate in the same period in 2019 (4·242). Furthermore, all monthly stillbirth rates during the first half of 2020 lie inside the 95% prediction interval of expected stillbirth rates for this period. Thus, stillbirths in Germany have neither increased nor decreased during the country’s first COVID-19 lockdown period.
In contrast to other European countries, stillbirth rates have been on the rise in Germany in the last decade. However, stillbirth rates during the first seven months of 2020 were not higher than expected. Our results suggest that stillbirth rates have neither increased nor decreased during the first-wave COVID-19 lockdown in this high-income setting. Further studies on the causes of the increasing stillbirth trend in Germany are needed, however.

The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.