Examining the Rise in Stillbirth Rates in Germany Compared to European Trends

In recent years, Germany has witnessed a troubling increase in stillbirth rates, a trend that starkly contrasts with the decline observed in many other European nations. Since 2010, the stillbirth rate in Germany has escalated from 2.8 stillbirths per 1,000 births to 3.7 in 2021, with Belgium being the only other European country to report a similar rise. In contrast, most European nations have either maintained stable rates or continued to see reductions.

This trend has prompted researchers from the Max Planck Institute for Demographic Research (MPIDR) to delve into the underlying factors contributing to these differences. Their findings, published in the European Journal of Public Health, suggest that while factors such as increasing maternal age and the prevalence of multiple births may play a role, they account for only a fraction of the observed variations in stillbirth rates across Europe.

Historically, stillbirth rates have improved throughout Europe, with most countries achieving rates below three stillbirths per 1,000 live births. However, Germany and Belgium have diverged from this trend, showing a significant increase in stillbirths since 2010. Specifically, Belgium's stillbirth rate increased from 4.6 to 5.6 per 1,000 births during the same period.

The study conducted by MPIDR researchers, in collaboration with institutions such as the University Medical Center Rotterdam and the National University Hospital of Iceland, analyzed data from the Euro-Peristat network. This network, established in 1999, aims to facilitate health monitoring across the EU. The researchers scrutinized annual stillbirth rates by maternal age and multiple births, adjusting their data to ensure consistent definitions of stillbirth across countries.

The results of the analysis indicated that, while stillbirth rates in most European countries are either declining or remaining stable, Germany and Belgium stand out with their persistent upward trends. In Germany, the stillbirth rate increased notably, while countries like Spain and Denmark experienced decreases, reflecting a broader trend of improvement in maternal and child health across the continent.

The researchers concluded that while advanced maternal age is associated with a heightened risk of stillbirth, it cannot fully explain the rising rates in Germany. Although the incidence of multiple births, which typically carries a higher stillbirth risk, has decreased in most countries, this decline has not been sufficient to offset the rising stillbirth rates in Germany.

Additionally, the study indicated that the demographic shifts regarding maternal age and multiple births are becoming more uniform across Europe. Nonetheless, Germany continues to exhibit a higher stillbirth rate compared to the average of the countries studied, suggesting that other factors are at play.

The researchers acknowledged the need for further exploration into the reasons behind the increasing stillbirth rates, particularly in Germany. They emphasized that stillbirth rates serve as a critical indicator of a country's healthcare system quality. If these rates are not declining, or are on the rise as observed in Germany, it necessitates a thorough investigation into the potential causes.

In conclusion, while maternal age and the prevalence of multiple births offer some insights into the rising stillbirth rates in Germany, they are not exhaustive explanations. The study highlights the complexity of the issue and the urgent need for further research to understand and address the factors contributing to stillbirths in Germany and Belgium.