Laboratory

Population Health

At a Glance Projects Publications Team

Project

Recent Trends in Fetal and Infant Mortality (Dissertation)

Maxi Kniffka, Jonas Schöley, Susie Lee

Detailed Description

High-income countries have reduced their stillbirth and infant mortality rates for several decades, but earliest mortality has recently started to rise or plateau in several countries. Whereas the rates continue to ebb in most countries, other countries struggle to improve their rates further. In this project, we investigate these trends in high-income settings. The project thus contributes to a newly emerging global challenge in earliest mortality and fills an important research gap.

Fetal and infant mortality is tragic for the dying human, who is deprived of maximum lifespan. But it is also shocking and traumatizing for the family that loses a child. Besides these emotional factors, fetal and infant death rates have been an indicator of the effectiveness of the health care system for long. A slowed down decrease or, even more importantly, mortality increase can be a sign of a health care system that is overloaded, malfunctioning, or both. These factors show how urgent it is to evaluate the changes in fetal and infant mortality and investigate their causes.

This project looks at different social and structural changes of the population. First, it examines the extent to which social inequalities have contributed to the recent trends in fetal and infant mortality. Second, it analyzes whether these mortality trends are the result of changes in population structure that lead to changes in fetal mortality without actually increasing mortality. Third, it examines the changes in mortality as such, for example, shifts caused by changes in the health care system or by economic challenges.

The project has so far focused on Germany. First findings have shown that stillbirth rates have been increasing since around 2010. This trend was not affected by the start of the COVID-19 pandemic. Stillbirth rates increased further in 2020 but not more than expected when compared to previous trends.

Publications

Kniffka, M. S.; Nitsche, N.; Rau, R.; Kühn, M.:

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

International Journal of Gynecology & Obstetrics 155:3, 483–489. (2021)