Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021

Background: Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burd...

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Main Author:	Comfort, Haley (author)
Other Authors:	McHugh, Theresa A (author), Schumacher, Austin E (author), Harris, Ashley (author), May, Erin A (author), Paulson, Katherine R (author), Gardner, William M (author), Fuller, John E (author), Frisch, Meghan E (author), Taylor, Heather Jean (author), Leever, Andrew T (author), Teply, Corey (author), Verghese, Nicholas Alexander (author), Alam, Tahiya (author), Abate, Yohannes Habtegiorgis (author), Abbastabar, Hedayat (author), Abd ElHafeez, Samar (author), Abdelmasseh, Michael (author), Abd-Elsalam, Sherief (author), Abdissa, Daba (author), Abdoun, Meriem (author), Abdulkader, Rizwan Suliankatchi (author), Abebe, Mesfin (author), Abedi, Aidin (author), Abidi, Hassan (author), Abiodun, Olumide (author), Aboagye, Richard Gyan (author), Abolhassani, Hassan (author), Abrigo, Michael R M (author), Abu-Gharbieh, Eman (author), Abu-Rmeileh, Niveen ME (author), Adane, Mesafint Molla (author), Addo, Isaac Yeboah (author), Adema, Bulcha Guye (author), Adesina, Miracle Ayomikun (author), Adetunji, Charles Oluwaseun Oluwaseun (author), Adeyinka, Daniel Adedayo (author), Adnani, Qorinah Estiningtyas Sakilah (author), Afzal, Saira (author), Agampodi, Suneth Buddhika (author), Agodi, Antonella (author), Agyemang-Duah, Williams (author), Ahinkorah, Bright Opoku (author), Ahmad, Aqeel (author), Ahmad, Danish (author), Ahmadi, Ali (author), Ahmed, Ayman (author), Ahmed, Haroon (author), Ahmed, Luai A (author), Ajami, Marjan (author), Akinosoglou, Karolina (author), Al Hasan, Syed Mahfuz (author), Al-Aly, Ziyad (author), Alam, Khurshid (author), Alanezi, Fahad Mashhour (author), Alanzi, Turki M (author), Albashtawy, Mohammed (author), Alemi, Sharifullah (author), Algammal, Abdelazeem M (author), Al-Gheethi, Adel Ali Saeed (author), Ali, Abid (author), Ali, Liaqat (author), Ali, Mohammed Usman (author), Alif, Sheikh Mohammad (author), Aljunid, Syed Mohamed (author), Almazan, Joseph Uy (author), Al-Mekhlafi, Hesham M (author), Almidani, Louay (author), Almustanyir, Sami (author), Altirkawi, Khalid A (author), Aly, Hany (author), Aly, Safwat (author), Amani, Reza (author), Ameyaw, Edward Kwabena (author), Amhare, Abebe Feyissa (author), Amin, Tarek Tawfik (author), Amiri, Sohrab (author), Andrei, Catalina Liliana (author), Andrei, Tudorel (author), Anoushiravani, Amir (author), Ansar, Adnan (author), Anvari, Davood (author), Anwer, Razique (author), Appiah, Francis (author), Arab-Zozani, Morteza (author), Aravkin, Aleksandr Y (author), Areda, Demelash (author), Aregawi, Brhane Berhe (author), Artamonov, Anton A (author), Aryal, Umesh Raj (author), Asemi, Zatollah (author), Asemu, Mulu Tiruneh (author), Asgedom, Akeza Awealom (author), Ashraf, Tahira (author), Asresie, Melash Belachew (author), Atlaw, Daniel (author), Atout, Maha Moh'd Wahbi (author), Atreya, Alok (author), Atteraya, Madhu Sudhan (author), Aujayeb, Avinash (author), Ayala Quintanilla, Beatriz Paulina (author), Ayatollahi, Haleh (author), Ayyoubzadeh, Seyed Mohammad (author), Azadnajafabad, Sina (author), Azevedo, Rui M S (author), Azzam, Ahmed Y (author), B, Darshan B (author), Babaei, Mahsa (author), Badar, Muhammad (author), Badiye, Ashish D (author), Baghcheghi, Nayereh (author), Baghdadi, Soroush (author), Bagheri, Nasser (author), Bagherieh, Sara (author), Bahrami Asl, Farshad (author), Bai, Ruhai (author), Bakshi, Ravleen Kaur (author), Bam, Kiran (author), Banach, Maciej (author), Banke-Thomas, Aduragbemi (author), Bansal, Hansi (author), Bantie, Berihun Bantie (author), Barchitta, Martina (author), Bardhan, Mainak (author), Bashiri, Azadeh (author), Basiru, Afisu (author), Baskaran, Pritish (author), Batra, Kavita (author), Bayani, Mojtaba (author), Bayleyegn, Nebiyou Simegnew (author), Bedi, Neeraj (author), Begum, Tahmina (author), Behnoush, Amir Hossein (author), Belgaumi, Uzma Iqbal (author), Bermudez, Amiel Nazer C (author), Beyene, Kebede A (author), Bhandari, Bharti Bhandari (author), Bhandari, Dinesh (author), Bhardwaj, Nikha (author), Bhardwaj, Pankaj (author), Bhaskar, Sonu (author), Bhattarai, Suraj (author), Bodolica, Virginia (author), Braithwaite, Dejana (author), Brenner, Hermann (author), Bustanji, Yasser (author), Butt, Nadeem Shafique (author), Butt, Zahid A (author), Cadri, Abdul (author), Campos-Nonato, Ismael (author), Cattaruzza, Maria Sofia (author), Cembranel, Francieli (author), Cerin, Ester (author), Chacón-Uscamaita, Pamela Roxana (author), Charan, Jaykaran (author), Chattu, Vijay Kumar (author), Chauhan, Dhun (author), Chavula, Malizgani Paul (author), Chen, Simiao (author), Chi, Gerald (author), Chitheer, Abdulaal (author), Cho, William C S (author), Choudhari, Sonali Gajanan (author), Chu, Dinh-Toi (author), Cruz-Martins, Natalia (author), Dadras, Omid (author), Dagnew, Gizachew Worku (author), Dalaba, Maxwell Ayindenaba (author), Dandona, Lalit (author), Darwesh, Aso Mohammad (author), Das, Jai K (author), Das, Saswati (author), Dash, Nihar Ranjan (author), Dávila-Cervantes, Claudio Alberto 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Format:	article
Published:	2024
Subjects:	Female Gestational Age Global Burden of Disease Global Health Humans Infant Mortality Infant Newborn Pregnancy Stillbirth
Online Access:	http://dx.doi.org/10.1016/S0140-6736(24)01925-1 https://www.sciencedirect.com/science/article/pii/S0140673624019251 http://hdl.handle.net/10576/62029
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author	Comfort, Haley
author2	McHugh, Theresa A Schumacher, Austin E Harris, Ashley May, Erin A Paulson, Katherine R Gardner, William M Fuller, John E Frisch, Meghan E Taylor, Heather Jean Leever, Andrew T Teply, Corey Verghese, Nicholas Alexander Alam, Tahiya Abate, Yohannes Habtegiorgis Abbastabar, Hedayat Abd ElHafeez, Samar Abdelmasseh, Michael Abd-Elsalam, Sherief Abdissa, Daba Abdoun, Meriem Abdulkader, Rizwan Suliankatchi Abebe, Mesfin Abedi, Aidin Abidi, Hassan Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Abrigo, Michael R M Abu-Gharbieh, Eman Abu-Rmeileh, Niveen ME Adane, Mesafint Molla Addo, Isaac Yeboah Adema, Bulcha Guye Adesina, Miracle Ayomikun Adetunji, Charles Oluwaseun Oluwaseun Adeyinka, Daniel Adedayo Adnani, Qorinah Estiningtyas Sakilah Afzal, Saira Agampodi, Suneth Buddhika Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmadi, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A Ajami, Marjan Akinosoglou, Karolina Al Hasan, Syed Mahfuz Al-Aly, Ziyad Alam, Khurshid Alanezi, Fahad Mashhour Alanzi, Turki M Albashtawy, Mohammed Alemi, Sharifullah Algammal, Abdelazeem M Al-Gheethi, Adel Ali Saeed Ali, Abid Ali, Liaqat Ali, Mohammed Usman Alif, Sheikh Mohammad Aljunid, Syed Mohamed Almazan, Joseph Uy Al-Mekhlafi, Hesham M Almidani, Louay Almustanyir, Sami Altirkawi, Khalid A Aly, Hany Aly, Safwat Amani, Reza Ameyaw, Edward Kwabena Amhare, Abebe Feyissa Amin, Tarek Tawfik Amiri, Sohrab Andrei, Catalina Liliana Andrei, Tudorel Anoushiravani, Amir Ansar, Adnan Anvari, Davood Anwer, Razique Appiah, Francis Arab-Zozani, Morteza Aravkin, Aleksandr Y Areda, Demelash Aregawi, Brhane Berhe Artamonov, Anton A Aryal, Umesh Raj Asemi, Zatollah Asemu, Mulu Tiruneh Asgedom, Akeza Awealom Ashraf, Tahira Asresie, Melash Belachew Atlaw, Daniel Atout, Maha Moh'd Wahbi Atreya, Alok Atteraya, Madhu Sudhan Aujayeb, Avinash Ayala Quintanilla, Beatriz Paulina Ayatollahi, Haleh Ayyoubzadeh, Seyed Mohammad Azadnajafabad, Sina Azevedo, Rui M S Azzam, Ahmed Y B, Darshan B Babaei, Mahsa Badar, Muhammad Badiye, Ashish D Baghcheghi, Nayereh Baghdadi, Soroush Bagheri, Nasser Bagherieh, Sara Bahrami Asl, Farshad Bai, Ruhai Bakshi, Ravleen Kaur Bam, Kiran Banach, Maciej Banke-Thomas, Aduragbemi Bansal, Hansi Bantie, Berihun Bantie Barchitta, Martina Bardhan, Mainak Bashiri, Azadeh Basiru, Afisu Baskaran, Pritish Batra, Kavita Bayani, Mojtaba Bayleyegn, Nebiyou Simegnew Bedi, Neeraj Begum, Tahmina Behnoush, Amir Hossein Belgaumi, Uzma Iqbal Bermudez, Amiel Nazer C Beyene, Kebede A Bhandari, Bharti Bhandari Bhandari, Dinesh Bhardwaj, Nikha Bhardwaj, Pankaj Bhaskar, Sonu Bhattarai, Suraj Bodolica, Virginia Braithwaite, Dejana Brenner, Hermann Bustanji, Yasser Butt, Nadeem Shafique Butt, Zahid A Cadri, Abdul Campos-Nonato, Ismael Cattaruzza, Maria Sofia Cembranel, Francieli Cerin, Ester Chacón-Uscamaita, Pamela Roxana Charan, Jaykaran Chattu, Vijay Kumar Chauhan, Dhun Chavula, Malizgani Paul Chen, Simiao Chi, Gerald Chitheer, Abdulaal Cho, William C S Choudhari, Sonali Gajanan Chu, Dinh-Toi Cruz-Martins, Natalia Dadras, Omid Dagnew, Gizachew Worku Dalaba, Maxwell Ayindenaba Dandona, Lalit Darwesh, Aso Mohammad Das, Jai K Das, Saswati Dash, Nihar Ranjan Dávila-Cervantes, Claudio Alberto Davletov, Kairat Debela, Berhanu Gidisa Debele, Aklilu Tamire Derese, Msganaw Deribe, Kebede Dervišević, Emina Dessie, Anteneh Mengist Dhali, Arkadeep Dhulipala, Vishal R Dirac, M Ashworth Dong, Wanyue Dora, Bezabih Terefe Dsouza, Haneil Larson Duraes, Andre Rodrigues Dutta, Sulagna Dziedzic, Arkadiusz Marian Ed-Dra, Abdelaziz Edvardsson, Kristina Eini, Ebrahim Ekholuenetale, Michael El Sayed Zaki, Maysaa Elgendy, Islam Y Elhadi, Muhammed Elshaer, Mohammed Elsohaby, Ibrahim Emeto, Theophilus I Engelbert Bain, Luchuo Esayas, Hawi Leul Eshrati, Babak Esposito, Francesco Fagbamigbe, Adeniyi Francis Fakhradiyev, Ildar Ravisovich Faramarzi, Ali Faro, Andre Fatehizadeh, Ali Fekadu, Ginenus Fischer, Florian Fomenkov, Artem Alekseevich Fukumoto, Takeshi Gaal, Peter Andras Gaidhane, Abhay Motiramji Gajdács, Márió Galali, Yaseen Gallus, Silvano Ganesan, Balasankar Gazzelloni, Federica Gebrehiwot, Mesfin Gebremedhin, Amanuel Tesfay Gebremeskel, Teferi Gebru Geda, Yohannes Fikadu Gezae, Kebede Embaye Ghazy, Ramy Mohamed Gheno, Gloria Gialluisi, Alessandro Gissler, Mika Glasbey, James C Glasstetter, Logan M Golechha, Mahaveer Goleij, Pouya Golinelli, Davide Grivna, Michal Guha, Avirup Guicciardi, Stefano Guo, Hanbing Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Haller, Sebastian Halwani, Rabih Hamidi, Samer Handal, Alexis J Haro, Josep Maria Hartman, Nicholas Nathaniel Hasan, Taufiq Hasanpour- Dehkordi, Ali Hasnain, Md Saquib Hassanipour, Soheil He, Wen-Qiang Heidari, Mohammad Herrera-Serna, Brenda Yuliana Herteliu, Claudiu Hessami, Kamran Hezam, Kamal Hiraike, Yuta Holla, Ramesh Hossain, Md Mahbub Hosseinzadeh, Hassan Hosseinzadeh, Mehdi Hostiuc, Mihaela Hostiuc, Sorin Hu, Chengxi Huang, Junjie Huda, M Mamun Huda, Md Nazmul Huynh, Hong-Han Hwang, Bing-Fang Iftikhar, Pulwasha Maria Ilesanmi, Olayinka Stephen Ilic, Irena M Ilic, Milena D Immurana, Mustapha Iranmehr, Arad Iravanpour, Farideh Iwagami, Masao Iwu, Chidozie Declan Iyasu, Assefa N Jaafari, Jalil Jafarzadeh, Abdollah Jahrami, Haitham Janodia, Manthan Dilipkumar Javadi, Nilofer Javaheri, Tahereh Jayapal, Sathish Kumar Jema, Alelign Tasew Jokar, Mohammad Joseph, Nitin Joshua, Charity Ehimwenma Jürisson, Mikk Kabir, Ali Kabir, Zubair Karaye, Ibraheem M Karimi, Hanie Kasraei, Hengameh Kauppila, Joonas H Kendal, Evie Shoshannah Keykhaei, Mohammad Khalid, Nauman Khamesipour, Faham Khan, M Nuruzzaman Khan, Maseer Khan, Yusra H Khatab, Khaled Khatatbeh, Haitham Khatatbeh, Moawiah Mohammad Khateri, Sorour Khayat Kashani, Hamid Reza Khormali, Moein Kim, Min Seo Kim, Thanh V Kim, Yun Jin Kimokoti, Ruth W Kisa, Adnan Kisa, Sezer Kochhar, Sonali Kolahi, Ali-Asghar Kompani, Farzad Koohestani, Hamid Reza Kosen, Soewarta Koyanagi, Ai Krishan, Kewal Krishnamoorthy, Vijay Kuate Defo, Barthelemy Kuchay, Raja Amir Hassan Kuddus, Mohammed Kumar, G Anil Kurmi, Om P La Vecchia, Carlo Lacey, Ben Lahariya, Chandrakant Laksono, Tri Lal, Dharmesh Kumar Lasrado, Savita Latief, Kamaluddin Latifinaibin, Kaveh Le, Thao Thi Thu Lee, Munjae Lee, Sang-woong Lee, Wei-Chen Lee, Yo Han Lenzi, Jacopo Li, Ming-Chieh Li, Shanshan Ligade, Virendra S Lim, Stephen S Liu, Gang Liu, Jue Liu, Xuefeng Lorenzovici, László Lotfizadeh, Masoud M Afifi, Ahmed Madureira-Carvalho, Áurea M Magee, Laura A Majeed, Azeem Malakan Rad, Elaheh Malhotra, Kashish Malik, Ahmad Azam Malik, Iram Mallhi, Tauqeer Hussain Maravilla, Joemer C Martini, Santi Martins-Melo, Francisco Rogerlândio Rogerlândio Martorell, Miquel Marzan, Melvin Barrientos Mathangasinghe, Yasith Mattiello, Rita Maugeri, Andrea Mayeli, Mahsa Mazaheri, Maryam Mediratta, Rishi P Mehrabani-Zeinabad, Kamran Meles, Gebrekiros Gebremichael Meles, Hadush Negash Mendez-Lopez, Max Alberto Mendoza, Walter Menezes, Ritesh G Meretoja, Atte Meretoja, Tuomo J Michalek, Irmina Maria Minh, Le Huu Nhat Mirfakhraie, Reza Mirghafourvand, Mojgan Mirica, Andreea Mirrakhimov, Erkin M Mirza, Moonis Mishio Bawa, Eric Misra, Sanjeev Mizana, Biru Abdissa Mohamed, Nouh Saad Mohammad-Alizadeh-Charandabi, Sakineh Mohammed, Ghada Mohammed, Salahuddin Mohammed, Shafiu Mokdad, Ali H Molinaro, Sabrina Momtazmanesh, Sara Monasta, Lorenzo Moni, Mohammad Ali Moodi Ghalibaf, AmirAli Moraga, Paula Morovatdar, Negar Mosapour, Abbas Mouodi, Simin Mousavi, Parsa Mueller, Ulrich Otto Mughal, Faraz Mulita, Admir Mulita, Francesk Muriithi, Moses K Nair, Tapas Sadasivan Najmuldeen, Hastyar Hama Rashid Nambi, Gopal Nangia, Vinay Nascimento, Gustavo G Nauman, Javaid Nejadghaderi, Seyed Aria Nematollahi, Mohammad Hadi Nguefack-Tsague, Georges Ngunjiri, Josephine W Nguyen, Dang H Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Phat Tuan Niazi, Robina Khan Nikoobar, Ali Nnyanzi, Lawrence Achilles Noman, Efaq Ali Nomura, Shuhei Noreen, Mamoona Nurrika, Dieta Nzoputam, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Oancea, Bogdan Obamiro, Kehinde O Ogunsakin, Ropo Ebenezer Okeke, Sylvester Reuben Okekunle, Akinkunmi Paul Okonji, Osaretin Christabel Okwute, Patrick Godwin Olagunju, Andrew T Olakunde, Babayemi Oluwaseun Olatubi, Matthew Idowu Olufadewa, Isaac Iyinoluwa Olusanya, Bolajoko Olubukunola Ordak, Michal Ortega-Altamirano, Doris V Osman, Wael M S Osuagwu, Uchechukwu Levi Otoiu, Adrian Otstavnov, Nikita Otstavnov, Stanislav S Ouyahia, Amel Owolabi, Mayowa O Padron-Monedero, Alicia Padubidri, Jagadish Rao Pana, Adrian Parija, Pragyan Paramita Parikh, Romil R Pashaei, Ava Patel, Sangram Kishor Patil, Shankargouda Pawar, Shrikant Pedersini, Paolo Pepito, Veincent Christian Filipino Peprah, Prince Pereira, Gavin Pereira, Jeevan Pereira, Marcos Pereira, Maria Odete Perianayagam, Arokiasamy Perico, Norberto Pesudovs, Konrad Petcu, Ionela-Roxana Petermann-Rocha, Fanny Emily Pezeshki, Parmida Sadat Pham, Tom Phan, My Kieu Philip, Anil K Pigeolet, Manon Piracha, Zahra Zahid Podder, Vivek Poddighe, Dimitri Pradhan, Pranil Man Singh Raeisi Shahraki, Hadi Raghav, Pankaja Rahman, Mosiur Rahmanian, Vahid Raimondo, Ivano Ramasamy, Shakthi Kumaran Ranabhat, Chhabi Lal Rancic, Nemanja Rao, Chythra R Rao, Sowmya J Rasella, Davide Rashid, Ahmed Mustafa Rawassizadeh, Reza Redwan, Elrashdy Moustafa Mohamed Remuzzi, Giuseppe Rengasamy, Kannan RR Renzaho, Andre M N Rezaei, Nazila Rezaei, Negar Rezaeian, Mohsen Robinson-Oden, Hannah Elizabeth Roever, Leonardo Rohloff, Peter Ronfani, Luca Rwegerera, Godfrey M Saad, Aly M A Saadatian, Zahra Sabour, Siamak Saddik, Basema Ahmad Sadeghi, Malihe Saeb, Mohammad Reza Saeed, Umar Saghazadeh, Amene Sagoe, Dominic Saheb Sharif-Askari, Fatemeh Saheb Sharif-Askari, Narjes Sahebkar, Amirhossein Sahoo, Harihar Sahoo, Soumya Swaroop Saleh, Mohamed A Salehi, Sana Salem, Marwa Rashad Samy, Abdallah M Sanjeev, Rama Krishna Sarikhani, Yaser Sarode, Sachin C Satpathy, Maheswar Sawhney, Monika Saya, Ganesh Kumar Saylan, Mete Schlaich, Markus P Schneider, Ione Jayce Ceola Schuermans, Art Sengupta, Pallav Senthilkumaran, Subramanian Sepanlou, Sadaf G Serban, Dragos SeyedAlinaghi, SeyedAhmad Seylani, Allen Shafie, Mahan Shah, Jaffer Shah, Pritik A Shahid, Samiah Shaikh, Masood Ali Sham, Sunder Shanawaz, Mohd Shannawaz, Mohammed Sharew, Mequannent Melaku Sharma, Manoj Shetty, Adithi Shetty, B Suresh Kumar Shetty, Pavanchand H Shiri, Rahman Shirkoohi, Reza Shivalli, Siddharudha Shool, Sina Shorofi, Seyed Afshin Shuja, Kanwar Hamza Shuval, Kerem Sibhat, Migbar Mekonnen Sidamo, Negussie Boti Silva, João Pedro Simpson, Colin R Singh, Jasvinder A Singh, Paramdeep Singh, Surjit Skhvitaridze, Natia Socea, Bogdan Sohag, Abdullah Al Mamun Soleimani, Hamidreza Solomon, Yonatan Song, Suhang Song, Yi Spartalis, Michael Sreeramareddy, Chandrashekhar T Stergachis, Andy Suleman, Muhammad Sultana, Saima Sun, Haitong Zhe Sun, Jing Szeto, Mindy D Tabarés-Seisdedos, Rafael Tabatabai, Shima Tabish, Mohammad Taheri, Majid Taheri Soodejani, Moslem Tamuzi, Jacques Lukenze Tan, Ker-Kan Tarigan, Ingan Ukur Tavakoli Oliaee, Razieh Taye, Birhan Tsegaw Tefera, Yibekal Manaye Temsah, Mohamad-Hani Teramoto, Masayuki Tesfamariam, Wegen Beyene Teye-Kwadjo, Enoch Tharwat, Samar Thavamani, Aravind Thomas, Nihal Titova, Mariya Vladimirovna Tiyuri, Amir Topor-Madry, Roman Tovani-Palone, Marcos Roberto Tripathy, Jaya Prasad Tromans, Samuel Joseph Ubah, Chukwudi S Umair, Muhammad Umakanthan, Srikanth Unim, Brigid Vaithinathan, Asokan Govindaraj Valadan Tahbaz, Sahel Valenti, Mario Valizadeh, Rohollah Van den Eynde, Jef Varthya, Shoban Babu Veroux, Massimiliano Verras, Georgios-Ioannis Villani, Leonardo Violante, Francesco S Vlassov, Vasily Walde, Mandaras Tariku Wang, Fang Wang, Shu Wang, Yanqing Wang, Yanzhong Wassie, Emebet Gashaw Weerakoon, Kosala Gayan Wolde, Asrat Arja Xu, Xiaoyue Yadav, Vikas Yang, Lin Yano, Yuichiro Yehualashet, Sisay Shewasinad Yi, Siyan Yiğit, Arzu Yiğit, Vahit Yip, Paul Yonemoto, Naohiro Zaki, Nazar Zamagni, Giulia Zaman, Burhan Abdullah Zastrozhin, Michael Zhang, Haijun Zhang, Yunquan Zhang, Zhi-Jiang Zhao, Hanqing Zhong, Claire Chenwen Zielińska, Magdalena Zuhriyah, Lilik Hay, Simon I Naghavi, Mohsen Murray, Christopher J L Dandona, Rakhi Kassebaum, Nicholas J
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
author_facet	Comfort, Haley McHugh, Theresa A Schumacher, Austin E Harris, Ashley May, Erin A Paulson, Katherine R Gardner, William M Fuller, John E Frisch, Meghan E Taylor, Heather Jean Leever, Andrew T Teply, Corey Verghese, Nicholas Alexander Alam, Tahiya Abate, Yohannes Habtegiorgis Abbastabar, Hedayat Abd ElHafeez, Samar Abdelmasseh, Michael Abd-Elsalam, Sherief Abdissa, Daba Abdoun, Meriem Abdulkader, Rizwan Suliankatchi Abebe, Mesfin Abedi, Aidin Abidi, Hassan Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Abrigo, Michael R M Abu-Gharbieh, Eman Abu-Rmeileh, Niveen ME Adane, Mesafint Molla Addo, Isaac Yeboah Adema, Bulcha Guye Adesina, Miracle Ayomikun Adetunji, Charles Oluwaseun Oluwaseun Adeyinka, Daniel Adedayo Adnani, Qorinah Estiningtyas Sakilah Afzal, Saira Agampodi, Suneth Buddhika Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmadi, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A Ajami, Marjan Akinosoglou, Karolina Al Hasan, Syed Mahfuz Al-Aly, Ziyad Alam, Khurshid Alanezi, Fahad Mashhour Alanzi, Turki M Albashtawy, Mohammed Alemi, Sharifullah Algammal, Abdelazeem M Al-Gheethi, Adel Ali Saeed Ali, Abid Ali, Liaqat Ali, Mohammed Usman Alif, Sheikh Mohammad Aljunid, Syed Mohamed Almazan, Joseph Uy Al-Mekhlafi, Hesham M Almidani, Louay Almustanyir, Sami Altirkawi, Khalid A Aly, Hany Aly, Safwat Amani, Reza Ameyaw, Edward Kwabena Amhare, Abebe Feyissa Amin, Tarek Tawfik Amiri, Sohrab Andrei, Catalina Liliana Andrei, Tudorel Anoushiravani, Amir Ansar, Adnan Anvari, Davood Anwer, Razique Appiah, Francis Arab-Zozani, Morteza Aravkin, Aleksandr Y Areda, Demelash Aregawi, Brhane Berhe Artamonov, Anton A Aryal, Umesh Raj Asemi, Zatollah Asemu, Mulu Tiruneh Asgedom, Akeza Awealom Ashraf, Tahira Asresie, Melash Belachew Atlaw, Daniel Atout, Maha Moh'd Wahbi Atreya, Alok Atteraya, Madhu Sudhan Aujayeb, Avinash Ayala Quintanilla, Beatriz Paulina Ayatollahi, Haleh Ayyoubzadeh, Seyed Mohammad Azadnajafabad, Sina Azevedo, Rui M S Azzam, Ahmed Y B, Darshan B Babaei, Mahsa Badar, Muhammad Badiye, Ashish D Baghcheghi, Nayereh Baghdadi, Soroush Bagheri, Nasser Bagherieh, Sara Bahrami Asl, Farshad Bai, Ruhai Bakshi, Ravleen Kaur Bam, Kiran Banach, Maciej Banke-Thomas, Aduragbemi Bansal, Hansi Bantie, Berihun Bantie Barchitta, Martina Bardhan, Mainak Bashiri, Azadeh Basiru, Afisu Baskaran, Pritish Batra, Kavita Bayani, Mojtaba Bayleyegn, Nebiyou Simegnew Bedi, Neeraj Begum, Tahmina Behnoush, Amir Hossein Belgaumi, Uzma Iqbal Bermudez, Amiel Nazer C Beyene, Kebede A Bhandari, Bharti Bhandari Bhandari, Dinesh Bhardwaj, Nikha Bhardwaj, Pankaj Bhaskar, Sonu Bhattarai, Suraj Bodolica, Virginia Braithwaite, Dejana Brenner, Hermann Bustanji, Yasser Butt, Nadeem Shafique Butt, Zahid A Cadri, Abdul Campos-Nonato, Ismael Cattaruzza, Maria Sofia Cembranel, Francieli Cerin, Ester Chacón-Uscamaita, Pamela Roxana Charan, Jaykaran Chattu, Vijay Kumar Chauhan, Dhun Chavula, Malizgani Paul Chen, Simiao Chi, Gerald Chitheer, Abdulaal Cho, William C S Choudhari, Sonali Gajanan Chu, Dinh-Toi Cruz-Martins, Natalia Dadras, Omid Dagnew, Gizachew Worku Dalaba, Maxwell Ayindenaba Dandona, Lalit Darwesh, Aso Mohammad Das, Jai K Das, Saswati Dash, Nihar Ranjan Dávila-Cervantes, Claudio Alberto Davletov, Kairat Debela, Berhanu Gidisa Debele, Aklilu Tamire Derese, Msganaw Deribe, Kebede Dervišević, Emina Dessie, Anteneh Mengist Dhali, Arkadeep Dhulipala, Vishal R Dirac, M Ashworth Dong, Wanyue Dora, Bezabih Terefe Dsouza, Haneil Larson Duraes, Andre Rodrigues Dutta, Sulagna Dziedzic, Arkadiusz Marian Ed-Dra, Abdelaziz Edvardsson, Kristina Eini, Ebrahim Ekholuenetale, Michael El Sayed Zaki, Maysaa Elgendy, Islam Y Elhadi, Muhammed Elshaer, Mohammed Elsohaby, Ibrahim Emeto, Theophilus I Engelbert Bain, Luchuo Esayas, Hawi Leul Eshrati, Babak Esposito, Francesco Fagbamigbe, Adeniyi Francis Fakhradiyev, Ildar Ravisovich Faramarzi, Ali Faro, Andre Fatehizadeh, Ali Fekadu, Ginenus Fischer, Florian Fomenkov, Artem Alekseevich Fukumoto, Takeshi Gaal, Peter Andras Gaidhane, Abhay Motiramji Gajdács, Márió Galali, Yaseen Gallus, Silvano Ganesan, Balasankar Gazzelloni, Federica Gebrehiwot, Mesfin Gebremedhin, Amanuel Tesfay Gebremeskel, Teferi Gebru Geda, Yohannes Fikadu Gezae, Kebede Embaye Ghazy, Ramy Mohamed Gheno, Gloria Gialluisi, Alessandro Gissler, Mika Glasbey, James C Glasstetter, Logan M Golechha, Mahaveer Goleij, Pouya Golinelli, Davide Grivna, Michal Guha, Avirup Guicciardi, Stefano Guo, Hanbing Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Haller, Sebastian Halwani, Rabih Hamidi, Samer Handal, Alexis J Haro, Josep Maria Hartman, Nicholas Nathaniel Hasan, Taufiq Hasanpour- Dehkordi, Ali Hasnain, Md Saquib Hassanipour, Soheil He, Wen-Qiang Heidari, Mohammad Herrera-Serna, Brenda Yuliana Herteliu, Claudiu Hessami, Kamran Hezam, Kamal Hiraike, Yuta Holla, Ramesh Hossain, Md Mahbub Hosseinzadeh, Hassan Hosseinzadeh, Mehdi Hostiuc, Mihaela Hostiuc, Sorin Hu, Chengxi Huang, Junjie Huda, M Mamun Huda, Md Nazmul Huynh, Hong-Han Hwang, Bing-Fang Iftikhar, Pulwasha Maria Ilesanmi, Olayinka Stephen Ilic, Irena M Ilic, Milena D Immurana, Mustapha Iranmehr, Arad Iravanpour, Farideh Iwagami, Masao Iwu, Chidozie Declan Iyasu, Assefa N Jaafari, Jalil Jafarzadeh, Abdollah Jahrami, Haitham Janodia, Manthan Dilipkumar Javadi, Nilofer Javaheri, Tahereh Jayapal, Sathish Kumar Jema, Alelign Tasew Jokar, Mohammad Joseph, Nitin Joshua, Charity Ehimwenma Jürisson, Mikk Kabir, Ali Kabir, Zubair Karaye, Ibraheem M Karimi, Hanie Kasraei, Hengameh Kauppila, Joonas H Kendal, Evie Shoshannah Keykhaei, Mohammad Khalid, Nauman Khamesipour, Faham Khan, M Nuruzzaman Khan, Maseer Khan, Yusra H Khatab, Khaled Khatatbeh, Haitham Khatatbeh, Moawiah Mohammad Khateri, Sorour Khayat Kashani, Hamid Reza Khormali, Moein Kim, Min Seo Kim, Thanh V Kim, Yun Jin Kimokoti, Ruth W Kisa, Adnan Kisa, Sezer Kochhar, Sonali Kolahi, Ali-Asghar Kompani, Farzad Koohestani, Hamid Reza Kosen, Soewarta Koyanagi, Ai Krishan, Kewal Krishnamoorthy, Vijay Kuate Defo, Barthelemy Kuchay, Raja Amir Hassan Kuddus, Mohammed Kumar, G Anil Kurmi, Om P La Vecchia, Carlo Lacey, Ben Lahariya, Chandrakant Laksono, Tri Lal, Dharmesh Kumar Lasrado, Savita Latief, Kamaluddin Latifinaibin, Kaveh Le, Thao Thi Thu Lee, Munjae Lee, Sang-woong Lee, Wei-Chen Lee, Yo Han Lenzi, Jacopo Li, Ming-Chieh Li, Shanshan Ligade, Virendra S Lim, Stephen S Liu, Gang Liu, Jue Liu, Xuefeng Lorenzovici, László Lotfizadeh, Masoud M Afifi, Ahmed Madureira-Carvalho, Áurea M Magee, Laura A Majeed, Azeem Malakan Rad, Elaheh Malhotra, Kashish Malik, Ahmad Azam Malik, Iram Mallhi, Tauqeer Hussain Maravilla, Joemer C Martini, Santi Martins-Melo, Francisco Rogerlândio Rogerlândio Martorell, Miquel Marzan, Melvin Barrientos Mathangasinghe, Yasith Mattiello, Rita Maugeri, Andrea Mayeli, Mahsa Mazaheri, Maryam Mediratta, Rishi P Mehrabani-Zeinabad, Kamran Meles, Gebrekiros Gebremichael Meles, Hadush Negash Mendez-Lopez, Max Alberto Mendoza, Walter Menezes, Ritesh G Meretoja, Atte Meretoja, Tuomo J Michalek, Irmina Maria Minh, Le Huu Nhat Mirfakhraie, Reza Mirghafourvand, Mojgan Mirica, Andreea Mirrakhimov, Erkin M Mirza, Moonis Mishio Bawa, Eric Misra, Sanjeev Mizana, Biru Abdissa Mohamed, Nouh Saad Mohammad-Alizadeh-Charandabi, Sakineh Mohammed, Ghada Mohammed, Salahuddin Mohammed, Shafiu Mokdad, Ali H Molinaro, Sabrina Momtazmanesh, Sara Monasta, Lorenzo Moni, Mohammad Ali Moodi Ghalibaf, AmirAli Moraga, Paula Morovatdar, Negar Mosapour, Abbas Mouodi, Simin Mousavi, Parsa Mueller, Ulrich Otto Mughal, Faraz Mulita, Admir Mulita, Francesk Muriithi, Moses K Nair, Tapas Sadasivan Najmuldeen, Hastyar Hama Rashid Nambi, Gopal Nangia, Vinay Nascimento, Gustavo G Nauman, Javaid Nejadghaderi, Seyed Aria Nematollahi, Mohammad Hadi Nguefack-Tsague, Georges Ngunjiri, Josephine W Nguyen, Dang H Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Phat Tuan Niazi, Robina Khan Nikoobar, Ali Nnyanzi, Lawrence Achilles Noman, Efaq Ali Nomura, Shuhei Noreen, Mamoona Nurrika, Dieta Nzoputam, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Oancea, Bogdan Obamiro, Kehinde O Ogunsakin, Ropo Ebenezer Okeke, Sylvester Reuben Okekunle, Akinkunmi Paul Okonji, Osaretin Christabel Okwute, Patrick Godwin Olagunju, Andrew T Olakunde, Babayemi Oluwaseun Olatubi, Matthew Idowu Olufadewa, Isaac Iyinoluwa Olusanya, Bolajoko Olubukunola Ordak, Michal Ortega-Altamirano, Doris V Osman, Wael M S Osuagwu, Uchechukwu Levi Otoiu, Adrian Otstavnov, Nikita Otstavnov, Stanislav S Ouyahia, Amel Owolabi, Mayowa O Padron-Monedero, Alicia Padubidri, Jagadish Rao Pana, Adrian Parija, Pragyan Paramita Parikh, Romil R Pashaei, Ava Patel, Sangram Kishor Patil, Shankargouda Pawar, Shrikant Pedersini, Paolo Pepito, Veincent Christian Filipino Peprah, Prince Pereira, Gavin Pereira, Jeevan Pereira, Marcos Pereira, Maria Odete Perianayagam, Arokiasamy Perico, Norberto Pesudovs, Konrad Petcu, Ionela-Roxana Petermann-Rocha, Fanny Emily Pezeshki, Parmida Sadat Pham, Tom Phan, My Kieu Philip, Anil K Pigeolet, Manon Piracha, Zahra Zahid Podder, Vivek Poddighe, Dimitri Pradhan, Pranil Man Singh Raeisi Shahraki, Hadi Raghav, Pankaja Rahman, Mosiur Rahmanian, Vahid Raimondo, Ivano Ramasamy, Shakthi Kumaran Ranabhat, Chhabi Lal Rancic, Nemanja Rao, Chythra R Rao, Sowmya J Rasella, Davide Rashid, Ahmed Mustafa Rawassizadeh, Reza Redwan, Elrashdy Moustafa Mohamed Remuzzi, Giuseppe Rengasamy, Kannan RR Renzaho, Andre M N Rezaei, Nazila Rezaei, Negar Rezaeian, Mohsen Robinson-Oden, Hannah Elizabeth Roever, Leonardo Rohloff, Peter Ronfani, Luca Rwegerera, Godfrey M Saad, Aly M A Saadatian, Zahra Sabour, Siamak Saddik, Basema Ahmad Sadeghi, Malihe Saeb, Mohammad Reza Saeed, Umar Saghazadeh, Amene Sagoe, Dominic Saheb Sharif-Askari, Fatemeh Saheb Sharif-Askari, Narjes Sahebkar, Amirhossein Sahoo, Harihar Sahoo, Soumya Swaroop Saleh, Mohamed A Salehi, Sana Salem, Marwa Rashad Samy, Abdallah M Sanjeev, Rama Krishna Sarikhani, Yaser Sarode, Sachin C Satpathy, Maheswar Sawhney, Monika Saya, Ganesh Kumar Saylan, Mete Schlaich, Markus P Schneider, Ione Jayce Ceola Schuermans, Art Sengupta, Pallav Senthilkumaran, Subramanian Sepanlou, Sadaf G Serban, Dragos SeyedAlinaghi, SeyedAhmad Seylani, Allen Shafie, Mahan Shah, Jaffer Shah, Pritik A Shahid, Samiah Shaikh, Masood Ali Sham, Sunder Shanawaz, Mohd Shannawaz, Mohammed Sharew, Mequannent Melaku Sharma, Manoj Shetty, Adithi Shetty, B Suresh Kumar Shetty, Pavanchand H Shiri, Rahman Shirkoohi, Reza Shivalli, Siddharudha Shool, Sina Shorofi, Seyed Afshin Shuja, Kanwar Hamza Shuval, Kerem Sibhat, Migbar Mekonnen Sidamo, Negussie Boti Silva, João Pedro Simpson, Colin R Singh, Jasvinder A Singh, Paramdeep Singh, Surjit Skhvitaridze, Natia Socea, Bogdan Sohag, Abdullah Al Mamun Soleimani, Hamidreza Solomon, Yonatan Song, Suhang Song, Yi Spartalis, Michael Sreeramareddy, Chandrashekhar T Stergachis, Andy Suleman, Muhammad Sultana, Saima Sun, Haitong Zhe Sun, Jing Szeto, Mindy D Tabarés-Seisdedos, Rafael Tabatabai, Shima Tabish, Mohammad Taheri, Majid Taheri Soodejani, Moslem Tamuzi, Jacques Lukenze Tan, Ker-Kan Tarigan, Ingan Ukur Tavakoli Oliaee, Razieh Taye, Birhan Tsegaw Tefera, Yibekal Manaye Temsah, Mohamad-Hani Teramoto, Masayuki Tesfamariam, Wegen Beyene Teye-Kwadjo, Enoch Tharwat, Samar Thavamani, Aravind Thomas, Nihal Titova, Mariya Vladimirovna Tiyuri, Amir Topor-Madry, Roman Tovani-Palone, Marcos Roberto Tripathy, Jaya Prasad Tromans, Samuel Joseph Ubah, Chukwudi S Umair, Muhammad Umakanthan, Srikanth Unim, Brigid Vaithinathan, Asokan Govindaraj Valadan Tahbaz, Sahel Valenti, Mario Valizadeh, Rohollah Van den Eynde, Jef Varthya, Shoban Babu Veroux, Massimiliano Verras, Georgios-Ioannis Villani, Leonardo Violante, Francesco S Vlassov, Vasily Walde, Mandaras Tariku Wang, Fang Wang, Shu Wang, Yanqing Wang, Yanzhong Wassie, Emebet Gashaw Weerakoon, Kosala Gayan Wolde, Asrat Arja Xu, Xiaoyue Yadav, Vikas Yang, Lin Yano, Yuichiro Yehualashet, Sisay Shewasinad Yi, Siyan Yiğit, Arzu Yiğit, Vahit Yip, Paul Yonemoto, Naohiro Zaki, Nazar Zamagni, Giulia Zaman, Burhan Abdullah Zastrozhin, Michael Zhang, Haijun Zhang, Yunquan Zhang, Zhi-Jiang Zhao, Hanqing Zhong, Claire Chenwen Zielińska, Magdalena Zuhriyah, Lilik Hay, Simon I Naghavi, Mohsen Murray, Christopher J L Dandona, Rakhi Kassebaum, Nicholas J
author_role	author
dc.creator.none.fl_str_mv	Comfort, Haley McHugh, Theresa A Schumacher, Austin E Harris, Ashley May, Erin A Paulson, Katherine R Gardner, William M Fuller, John E Frisch, Meghan E Taylor, Heather Jean Leever, Andrew T Teply, Corey Verghese, Nicholas Alexander Alam, Tahiya Abate, Yohannes Habtegiorgis Abbastabar, Hedayat Abd ElHafeez, Samar Abdelmasseh, Michael Abd-Elsalam, Sherief Abdissa, Daba Abdoun, Meriem Abdulkader, Rizwan Suliankatchi Abebe, Mesfin Abedi, Aidin Abidi, Hassan Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Abrigo, Michael R M Abu-Gharbieh, Eman Abu-Rmeileh, Niveen ME Adane, Mesafint Molla Addo, Isaac Yeboah Adema, Bulcha Guye Adesina, Miracle Ayomikun Adetunji, Charles Oluwaseun Oluwaseun Adeyinka, Daniel Adedayo Adnani, Qorinah Estiningtyas Sakilah Afzal, Saira Agampodi, Suneth Buddhika Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmadi, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A Ajami, Marjan Akinosoglou, Karolina Al Hasan, Syed Mahfuz Al-Aly, Ziyad Alam, Khurshid Alanezi, Fahad Mashhour Alanzi, Turki M Albashtawy, Mohammed Alemi, Sharifullah Algammal, Abdelazeem M Al-Gheethi, Adel Ali Saeed Ali, Abid Ali, Liaqat Ali, Mohammed Usman Alif, Sheikh Mohammad Aljunid, Syed Mohamed Almazan, Joseph Uy Al-Mekhlafi, Hesham M Almidani, Louay Almustanyir, Sami Altirkawi, Khalid A Aly, Hany Aly, Safwat Amani, Reza Ameyaw, Edward Kwabena Amhare, Abebe Feyissa Amin, Tarek Tawfik Amiri, Sohrab Andrei, Catalina Liliana Andrei, Tudorel Anoushiravani, Amir Ansar, Adnan Anvari, Davood Anwer, Razique Appiah, Francis Arab-Zozani, Morteza Aravkin, Aleksandr Y Areda, Demelash Aregawi, Brhane Berhe Artamonov, Anton A Aryal, Umesh Raj Asemi, Zatollah Asemu, Mulu Tiruneh Asgedom, Akeza Awealom Ashraf, Tahira Asresie, Melash Belachew Atlaw, Daniel Atout, Maha Moh'd Wahbi Atreya, Alok Atteraya, Madhu Sudhan Aujayeb, Avinash Ayala Quintanilla, Beatriz Paulina Ayatollahi, Haleh Ayyoubzadeh, Seyed Mohammad Azadnajafabad, Sina Azevedo, Rui M S Azzam, Ahmed Y B, Darshan B Babaei, Mahsa Badar, Muhammad Badiye, Ashish D Baghcheghi, Nayereh Baghdadi, Soroush Bagheri, Nasser Bagherieh, Sara Bahrami Asl, Farshad Bai, Ruhai Bakshi, Ravleen Kaur Bam, Kiran Banach, Maciej Banke-Thomas, Aduragbemi Bansal, Hansi Bantie, Berihun Bantie Barchitta, Martina Bardhan, Mainak Bashiri, Azadeh Basiru, Afisu Baskaran, Pritish Batra, Kavita Bayani, Mojtaba Bayleyegn, Nebiyou Simegnew Bedi, Neeraj Begum, Tahmina Behnoush, Amir Hossein Belgaumi, Uzma Iqbal Bermudez, Amiel Nazer C Beyene, Kebede A Bhandari, Bharti Bhandari Bhandari, Dinesh Bhardwaj, Nikha Bhardwaj, Pankaj Bhaskar, Sonu Bhattarai, Suraj Bodolica, Virginia Braithwaite, Dejana Brenner, Hermann Bustanji, Yasser Butt, Nadeem Shafique Butt, Zahid A Cadri, Abdul Campos-Nonato, Ismael Cattaruzza, Maria Sofia Cembranel, Francieli Cerin, Ester Chacón-Uscamaita, Pamela Roxana Charan, Jaykaran Chattu, Vijay Kumar Chauhan, Dhun Chavula, Malizgani Paul Chen, Simiao Chi, Gerald Chitheer, Abdulaal Cho, William C S Choudhari, Sonali Gajanan Chu, Dinh-Toi Cruz-Martins, Natalia Dadras, Omid Dagnew, Gizachew Worku Dalaba, Maxwell Ayindenaba Dandona, Lalit Darwesh, Aso Mohammad Das, Jai K Das, Saswati Dash, Nihar Ranjan Dávila-Cervantes, Claudio Alberto Davletov, Kairat Debela, Berhanu Gidisa Debele, Aklilu Tamire Derese, Msganaw Deribe, Kebede Dervišević, Emina Dessie, Anteneh Mengist Dhali, Arkadeep Dhulipala, Vishal R Dirac, M Ashworth Dong, Wanyue Dora, Bezabih Terefe Dsouza, Haneil Larson Duraes, Andre Rodrigues Dutta, Sulagna Dziedzic, Arkadiusz Marian Ed-Dra, Abdelaziz Edvardsson, Kristina Eini, Ebrahim Ekholuenetale, Michael El Sayed Zaki, Maysaa Elgendy, Islam Y Elhadi, Muhammed Elshaer, Mohammed Elsohaby, Ibrahim Emeto, Theophilus I Engelbert Bain, Luchuo Esayas, Hawi Leul Eshrati, Babak Esposito, Francesco Fagbamigbe, Adeniyi Francis Fakhradiyev, Ildar Ravisovich Faramarzi, Ali Faro, Andre Fatehizadeh, Ali Fekadu, Ginenus Fischer, Florian Fomenkov, Artem Alekseevich Fukumoto, Takeshi Gaal, Peter Andras Gaidhane, Abhay Motiramji Gajdács, Márió Galali, Yaseen Gallus, Silvano Ganesan, Balasankar Gazzelloni, Federica Gebrehiwot, Mesfin Gebremedhin, Amanuel Tesfay Gebremeskel, Teferi Gebru Geda, Yohannes Fikadu Gezae, Kebede Embaye Ghazy, Ramy Mohamed Gheno, Gloria Gialluisi, Alessandro Gissler, Mika Glasbey, James C Glasstetter, Logan M Golechha, Mahaveer Goleij, Pouya Golinelli, Davide Grivna, Michal Guha, Avirup Guicciardi, Stefano Guo, Hanbing Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Haller, Sebastian Halwani, Rabih Hamidi, Samer Handal, Alexis J Haro, Josep Maria Hartman, Nicholas Nathaniel Hasan, Taufiq Hasanpour- Dehkordi, Ali Hasnain, Md Saquib Hassanipour, Soheil He, Wen-Qiang Heidari, Mohammad Herrera-Serna, Brenda Yuliana Herteliu, Claudiu Hessami, Kamran Hezam, Kamal Hiraike, Yuta Holla, Ramesh Hossain, Md Mahbub Hosseinzadeh, Hassan Hosseinzadeh, Mehdi Hostiuc, Mihaela Hostiuc, Sorin Hu, Chengxi Huang, Junjie Huda, M Mamun Huda, Md Nazmul Huynh, Hong-Han Hwang, Bing-Fang Iftikhar, Pulwasha Maria Ilesanmi, Olayinka Stephen Ilic, Irena M Ilic, Milena D Immurana, Mustapha Iranmehr, Arad Iravanpour, Farideh Iwagami, Masao Iwu, Chidozie Declan Iyasu, Assefa N Jaafari, Jalil Jafarzadeh, Abdollah Jahrami, Haitham Janodia, Manthan Dilipkumar Javadi, Nilofer Javaheri, Tahereh Jayapal, Sathish Kumar Jema, Alelign Tasew Jokar, Mohammad Joseph, Nitin Joshua, Charity Ehimwenma Jürisson, Mikk Kabir, Ali Kabir, Zubair Karaye, Ibraheem M Karimi, Hanie Kasraei, Hengameh Kauppila, Joonas H Kendal, Evie Shoshannah Keykhaei, Mohammad Khalid, Nauman Khamesipour, Faham Khan, M Nuruzzaman Khan, Maseer Khan, Yusra H Khatab, Khaled Khatatbeh, Haitham Khatatbeh, Moawiah Mohammad Khateri, Sorour Khayat Kashani, Hamid Reza Khormali, Moein Kim, Min Seo Kim, Thanh V Kim, Yun Jin Kimokoti, Ruth W Kisa, Adnan Kisa, Sezer Kochhar, Sonali Kolahi, Ali-Asghar Kompani, Farzad Koohestani, Hamid Reza Kosen, Soewarta Koyanagi, Ai Krishan, Kewal Krishnamoorthy, Vijay Kuate Defo, Barthelemy Kuchay, Raja Amir Hassan Kuddus, Mohammed Kumar, G Anil Kurmi, Om P La Vecchia, Carlo Lacey, Ben Lahariya, Chandrakant Laksono, Tri Lal, Dharmesh Kumar Lasrado, Savita Latief, Kamaluddin Latifinaibin, Kaveh Le, Thao Thi Thu Lee, Munjae Lee, Sang-woong Lee, Wei-Chen Lee, Yo Han Lenzi, Jacopo Li, Ming-Chieh Li, Shanshan Ligade, Virendra S Lim, Stephen S Liu, Gang Liu, Jue Liu, Xuefeng Lorenzovici, László Lotfizadeh, Masoud M Afifi, Ahmed Madureira-Carvalho, Áurea M Magee, Laura A Majeed, Azeem Malakan Rad, Elaheh Malhotra, Kashish Malik, Ahmad Azam Malik, Iram Mallhi, Tauqeer Hussain Maravilla, Joemer C Martini, Santi Martins-Melo, Francisco Rogerlândio Rogerlândio Martorell, Miquel Marzan, Melvin Barrientos Mathangasinghe, Yasith Mattiello, Rita Maugeri, Andrea Mayeli, Mahsa Mazaheri, Maryam Mediratta, Rishi P Mehrabani-Zeinabad, Kamran Meles, Gebrekiros Gebremichael Meles, Hadush Negash Mendez-Lopez, Max Alberto Mendoza, Walter Menezes, Ritesh G Meretoja, Atte Meretoja, Tuomo J Michalek, Irmina Maria Minh, Le Huu Nhat Mirfakhraie, Reza Mirghafourvand, Mojgan Mirica, Andreea Mirrakhimov, Erkin M Mirza, Moonis Mishio Bawa, Eric Misra, Sanjeev Mizana, Biru Abdissa Mohamed, Nouh Saad Mohammad-Alizadeh-Charandabi, Sakineh Mohammed, Ghada Mohammed, Salahuddin Mohammed, Shafiu Mokdad, Ali H Molinaro, Sabrina Momtazmanesh, Sara Monasta, Lorenzo Moni, Mohammad Ali Moodi Ghalibaf, AmirAli Moraga, Paula Morovatdar, Negar Mosapour, Abbas Mouodi, Simin Mousavi, Parsa Mueller, Ulrich Otto Mughal, Faraz Mulita, Admir Mulita, Francesk Muriithi, Moses K Nair, Tapas Sadasivan Najmuldeen, Hastyar Hama Rashid Nambi, Gopal Nangia, Vinay Nascimento, Gustavo G Nauman, Javaid Nejadghaderi, Seyed Aria Nematollahi, Mohammad Hadi Nguefack-Tsague, Georges Ngunjiri, Josephine W Nguyen, Dang H Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Phat Tuan Niazi, Robina Khan Nikoobar, Ali Nnyanzi, Lawrence Achilles Noman, Efaq Ali Nomura, Shuhei Noreen, Mamoona Nurrika, Dieta Nzoputam, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Oancea, Bogdan Obamiro, Kehinde O Ogunsakin, Ropo Ebenezer Okeke, Sylvester Reuben Okekunle, Akinkunmi Paul Okonji, Osaretin Christabel Okwute, Patrick Godwin Olagunju, Andrew T Olakunde, Babayemi Oluwaseun Olatubi, Matthew Idowu Olufadewa, Isaac Iyinoluwa Olusanya, Bolajoko Olubukunola Ordak, Michal Ortega-Altamirano, Doris V Osman, Wael M S Osuagwu, Uchechukwu Levi Otoiu, Adrian Otstavnov, Nikita Otstavnov, Stanislav S Ouyahia, Amel Owolabi, Mayowa O Padron-Monedero, Alicia Padubidri, Jagadish Rao Pana, Adrian Parija, Pragyan Paramita Parikh, Romil R Pashaei, Ava Patel, Sangram Kishor Patil, Shankargouda Pawar, Shrikant Pedersini, Paolo Pepito, Veincent Christian Filipino Peprah, Prince Pereira, Gavin Pereira, Jeevan Pereira, Marcos Pereira, Maria Odete Perianayagam, Arokiasamy Perico, Norberto Pesudovs, Konrad Petcu, Ionela-Roxana Petermann-Rocha, Fanny Emily Pezeshki, Parmida Sadat Pham, Tom Phan, My Kieu Philip, Anil K Pigeolet, Manon Piracha, Zahra Zahid Podder, Vivek Poddighe, Dimitri Pradhan, Pranil Man Singh Raeisi Shahraki, Hadi Raghav, Pankaja Rahman, Mosiur Rahmanian, Vahid Raimondo, Ivano Ramasamy, Shakthi Kumaran Ranabhat, Chhabi Lal Rancic, Nemanja Rao, Chythra R Rao, Sowmya J Rasella, Davide Rashid, Ahmed Mustafa Rawassizadeh, Reza Redwan, Elrashdy Moustafa Mohamed Remuzzi, Giuseppe Rengasamy, Kannan RR Renzaho, Andre M N Rezaei, Nazila Rezaei, Negar Rezaeian, Mohsen Robinson-Oden, Hannah Elizabeth Roever, Leonardo Rohloff, Peter Ronfani, Luca Rwegerera, Godfrey M Saad, Aly M A Saadatian, Zahra Sabour, Siamak Saddik, Basema Ahmad Sadeghi, Malihe Saeb, Mohammad Reza Saeed, Umar Saghazadeh, Amene Sagoe, Dominic Saheb Sharif-Askari, Fatemeh Saheb Sharif-Askari, Narjes Sahebkar, Amirhossein Sahoo, Harihar Sahoo, Soumya Swaroop Saleh, Mohamed A Salehi, Sana Salem, Marwa Rashad Samy, Abdallah M Sanjeev, Rama Krishna Sarikhani, Yaser Sarode, Sachin C Satpathy, Maheswar Sawhney, Monika Saya, Ganesh Kumar Saylan, Mete Schlaich, Markus P Schneider, Ione Jayce Ceola Schuermans, Art Sengupta, Pallav Senthilkumaran, Subramanian Sepanlou, Sadaf G Serban, Dragos SeyedAlinaghi, SeyedAhmad Seylani, Allen Shafie, Mahan Shah, Jaffer Shah, Pritik A Shahid, Samiah Shaikh, Masood Ali Sham, Sunder Shanawaz, Mohd Shannawaz, Mohammed Sharew, Mequannent Melaku Sharma, Manoj Shetty, Adithi Shetty, B Suresh Kumar Shetty, Pavanchand H Shiri, Rahman Shirkoohi, Reza Shivalli, Siddharudha Shool, Sina Shorofi, Seyed Afshin Shuja, Kanwar Hamza Shuval, Kerem Sibhat, Migbar Mekonnen Sidamo, Negussie Boti Silva, João Pedro Simpson, Colin R Singh, Jasvinder A Singh, Paramdeep Singh, Surjit Skhvitaridze, Natia Socea, Bogdan Sohag, Abdullah Al Mamun Soleimani, Hamidreza Solomon, Yonatan Song, Suhang Song, Yi Spartalis, Michael Sreeramareddy, Chandrashekhar T Stergachis, Andy Suleman, Muhammad Sultana, Saima Sun, Haitong Zhe Sun, Jing Szeto, Mindy D Tabarés-Seisdedos, Rafael Tabatabai, Shima Tabish, Mohammad Taheri, Majid Taheri Soodejani, Moslem Tamuzi, Jacques Lukenze Tan, Ker-Kan Tarigan, Ingan Ukur Tavakoli Oliaee, Razieh Taye, Birhan Tsegaw Tefera, Yibekal Manaye Temsah, Mohamad-Hani Teramoto, Masayuki Tesfamariam, Wegen Beyene Teye-Kwadjo, Enoch Tharwat, Samar Thavamani, Aravind Thomas, Nihal Titova, Mariya Vladimirovna Tiyuri, Amir Topor-Madry, Roman Tovani-Palone, Marcos Roberto Tripathy, Jaya Prasad Tromans, Samuel Joseph Ubah, Chukwudi S Umair, Muhammad Umakanthan, Srikanth Unim, Brigid Vaithinathan, Asokan Govindaraj Valadan Tahbaz, Sahel Valenti, Mario Valizadeh, Rohollah Van den Eynde, Jef Varthya, Shoban Babu Veroux, Massimiliano Verras, Georgios-Ioannis Villani, Leonardo Violante, Francesco S Vlassov, Vasily Walde, Mandaras Tariku Wang, Fang Wang, Shu Wang, Yanqing Wang, Yanzhong Wassie, Emebet Gashaw Weerakoon, Kosala Gayan Wolde, Asrat Arja Xu, Xiaoyue Yadav, Vikas Yang, Lin Yano, Yuichiro Yehualashet, Sisay Shewasinad Yi, Siyan Yiğit, Arzu Yiğit, Vahit Yip, Paul Yonemoto, Naohiro Zaki, Nazar Zamagni, Giulia Zaman, Burhan Abdullah Zastrozhin, Michael Zhang, Haijun Zhang, Yunquan Zhang, Zhi-Jiang Zhao, Hanqing Zhong, Claire Chenwen Zielińska, Magdalena Zuhriyah, Lilik Hay, Simon I Naghavi, Mohsen Murray, Christopher J L Dandona, Rakhi Kassebaum, Nicholas J
dc.date.none.fl_str_mv	2024-12-26T07:55:17Z 2024-11-04
dc.format.none.fl_str_mv	application/pdf
dc.identifier.none.fl_str_mv	http://dx.doi.org/10.1016/S0140-6736(24)01925-1 Comfort, Haley et al.(2024).Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021, The Lancet, 404(10466), pp. 1955 - 1988 0140-6736 https://www.sciencedirect.com/science/article/pii/S0140673624019251 http://hdl.handle.net/10576/62029 1955 - 1988 10466 404 1474-547X
dc.language.none.fl_str_mv	en
dc.publisher.none.fl_str_mv	Elsevier Ltd.
dc.rights.none.fl_str_mv	http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv	Female Gestational Age Global Burden of Disease Global Health Humans Infant Mortality Infant Newborn Pregnancy Stillbirth
dc.title.none.fl_str_mv	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
dc.type.none.fl_str_mv	Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article
description	Background: Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, methodically accounted for different stillbirth definitions with the aim of comprehensively estimating all stillbirths at 20 weeks or longer for 204 countries and territories from 1990 to 2021. Methods: We extracted data on stillbirths from 11 412 sources across 185 of 204 countries and territories, including 234 surveys, 231 published studies, 1633 vital statistics reports, and 10 585 unique location-year combinations from vital registration systems. Our final dataset comprised 11 different definitions, which were adjusted to match two gestational age thresholds: 20 weeks or longer (reference) and 28 weeks or longer (for comparisons). We modelled the ratio of stillbirth rate to neonatal mortality rate with spatiotemporal Gaussian process regression for each location and year, and then used final GBD 2021 assessments of fertility and all-cause neonatal mortality to calculate total stillbirths. Secondary analyses evaluated the number of stillbirths missed with the more restrictive gestational age definition, trends in stillbirths as a function of Socio-demographic Index, and progress in reducing stillbirths relative to neonatal deaths. Findings: In 2021, the global stillbirth rate was 23·0 (95% uncertainty interval [UI] 19·7–27·2) per 1000 births (stillbirths plus livebirths) at 20 weeks' gestation or longer, compared to 16·1 (13·9–19·0) per 1000 births at 28 weeks' gestation or longer. The global neonatal mortality rate in 2021 was 17·1 (14·8–19·9) per 1000 livebirths, corresponding to 2·19 million (1·90–2·55) neonatal deaths. The estimated number of stillbirths occurring at 20 weeks' gestation or longer decreased from 5·08 million (95% UI 4·07–6·35) in 1990 to 3·04 million (2·61–3·62) in 2021, corresponding to a 39·8% (31·8–48·0) reduction, which lagged behind a global improvement in neonatal deaths of 45·6% (36·3–53·1) for the same period (down from 4·03 million [3·86–4·22] neonatal deaths in 1990). Stillbirths in south Asia and sub-Saharan Africa comprised 77·4% (2·35 million of 3·04 million) of the global total, an increase from 60·3% (3·07 million of 5·08 million) in 1990. In 2021, 0·926 million (0·792–1·10) stillbirths, corresponding to 30·5% of the global total (3·04 million), occurred between 20 weeks' gestation and 28 weeks' gestation, with substantial variation at the country level. Interpretation: Despite the gradual global decline in stillbirths between 1990 and 2021, the overall number of stillbirths remains substantially high. Counting all stillbirths is paramount to progress, as nearly a third—close to 1 million in total—are left uncounted at the 28 weeks or longer threshold. Our findings draw attention to the differential progress in reducing stillbirths, with a high burden concentrated in countries with low development status. Scarce data availability and poor data quality constrain our capacity to precisely account for stillbirths in many locations. Addressing inequities in universal maternal health coverage, strengthening the quality of maternal health care, and improving the robustness of data systems are urgently needed to reduce the global burden of stillbirths. Funding: Bill & Melinda Gates Foundation.
eu_rights_str_mv	openAccess
format	article
id	qu_fe57b6d2d9ccc7dc92bf649d209232ee
identifier_str_mv	Comfort, Haley et al.(2024).Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021, The Lancet, 404(10466), pp. 1955 - 1988 0140-6736 1955 - 1988 10466 404 1474-547X
language_invalid_str_mv	en
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network_name_str	Qatar University repository
oai_identifier_str	oai:qspace.qu.edu.qa:10576/62029
publishDate	2024
publisher.none.fl_str_mv	Elsevier Ltd.
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rights_invalid_str_mv	http://creativecommons.org/licenses/by/4.0/
spelling	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021Comfort, HaleyMcHugh, Theresa ASchumacher, Austin EHarris, AshleyMay, Erin APaulson, Katherine RGardner, William MFuller, John EFrisch, Meghan ETaylor, Heather JeanLeever, Andrew TTeply, CoreyVerghese, Nicholas AlexanderAlam, TahiyaAbate, Yohannes HabtegiorgisAbbastabar, HedayatAbd ElHafeez, SamarAbdelmasseh, MichaelAbd-Elsalam, SheriefAbdissa, DabaAbdoun, MeriemAbdulkader, Rizwan SuliankatchiAbebe, MesfinAbedi, AidinAbidi, HassanAbiodun, OlumideAboagye, Richard GyanAbolhassani, HassanAbrigo, Michael R MAbu-Gharbieh, EmanAbu-Rmeileh, Niveen MEAdane, Mesafint MollaAddo, Isaac YeboahAdema, Bulcha GuyeAdesina, Miracle AyomikunAdetunji, Charles Oluwaseun OluwaseunAdeyinka, Daniel AdedayoAdnani, Qorinah Estiningtyas SakilahAfzal, SairaAgampodi, Suneth BuddhikaAgodi, AntonellaAgyemang-Duah, WilliamsAhinkorah, Bright OpokuAhmad, AqeelAhmad, DanishAhmadi, AliAhmed, AymanAhmed, HaroonAhmed, Luai AAjami, MarjanAkinosoglou, KarolinaAl Hasan, Syed MahfuzAl-Aly, ZiyadAlam, KhurshidAlanezi, Fahad MashhourAlanzi, Turki MAlbashtawy, MohammedAlemi, SharifullahAlgammal, Abdelazeem MAl-Gheethi, Adel Ali SaeedAli, AbidAli, LiaqatAli, Mohammed UsmanAlif, Sheikh MohammadAljunid, Syed MohamedAlmazan, Joseph UyAl-Mekhlafi, Hesham MAlmidani, LouayAlmustanyir, SamiAltirkawi, Khalid AAly, HanyAly, SafwatAmani, RezaAmeyaw, Edward KwabenaAmhare, Abebe FeyissaAmin, Tarek TawfikAmiri, SohrabAndrei, Catalina LilianaAndrei, TudorelAnoushiravani, AmirAnsar, AdnanAnvari, DavoodAnwer, RaziqueAppiah, FrancisArab-Zozani, MortezaAravkin, Aleksandr YAreda, DemelashAregawi, Brhane BerheArtamonov, Anton AAryal, Umesh RajAsemi, ZatollahAsemu, Mulu TirunehAsgedom, Akeza AwealomAshraf, TahiraAsresie, Melash BelachewAtlaw, DanielAtout, Maha Moh'd WahbiAtreya, AlokAtteraya, Madhu SudhanAujayeb, AvinashAyala Quintanilla, Beatriz 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SimiaoChi, GeraldChitheer, AbdulaalCho, William C SChoudhari, Sonali GajananChu, Dinh-ToiCruz-Martins, NataliaDadras, OmidDagnew, Gizachew WorkuDalaba, Maxwell AyindenabaDandona, LalitDarwesh, Aso MohammadDas, Jai KDas, SaswatiDash, Nihar RanjanDávila-Cervantes, Claudio AlbertoDavletov, KairatDebela, Berhanu GidisaDebele, Aklilu TamireDerese, MsganawDeribe, KebedeDervišević, EminaDessie, Anteneh MengistDhali, ArkadeepDhulipala, Vishal RDirac, M AshworthDong, WanyueDora, Bezabih TerefeDsouza, Haneil LarsonDuraes, Andre RodriguesDutta, SulagnaDziedzic, Arkadiusz MarianEd-Dra, AbdelazizEdvardsson, KristinaEini, EbrahimEkholuenetale, MichaelEl Sayed Zaki, MaysaaElgendy, Islam YElhadi, MuhammedElshaer, MohammedElsohaby, IbrahimEmeto, Theophilus IEngelbert Bain, LuchuoEsayas, Hawi LeulEshrati, BabakEsposito, FrancescoFagbamigbe, Adeniyi FrancisFakhradiyev, Ildar RavisovichFaramarzi, AliFaro, AndreFatehizadeh, AliFekadu, GinenusFischer, FlorianFomenkov, Artem AlekseevichFukumoto, TakeshiGaal, 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Mequannent MelakuSharma, ManojShetty, AdithiShetty, B Suresh KumarShetty, Pavanchand HShiri, RahmanShirkoohi, RezaShivalli, SiddharudhaShool, SinaShorofi, Seyed AfshinShuja, Kanwar HamzaShuval, KeremSibhat, Migbar MekonnenSidamo, Negussie BotiSilva, João PedroSimpson, Colin RSingh, Jasvinder ASingh, ParamdeepSingh, SurjitSkhvitaridze, NatiaSocea, BogdanSohag, Abdullah Al MamunSoleimani, HamidrezaSolomon, YonatanSong, SuhangSong, YiSpartalis, MichaelSreeramareddy, Chandrashekhar TStergachis, AndySuleman, MuhammadSultana, SaimaSun, Haitong ZheSun, JingSzeto, Mindy DTabarés-Seisdedos, RafaelTabatabai, ShimaTabish, MohammadTaheri, MajidTaheri Soodejani, MoslemTamuzi, Jacques LukenzeTan, Ker-KanTarigan, Ingan UkurTavakoli Oliaee, RaziehTaye, Birhan TsegawTefera, Yibekal ManayeTemsah, Mohamad-HaniTeramoto, MasayukiTesfamariam, Wegen BeyeneTeye-Kwadjo, EnochTharwat, SamarThavamani, AravindThomas, NihalTitova, Mariya VladimirovnaTiyuri, AmirTopor-Madry, RomanTovani-Palone, Marcos RobertoTripathy, Jaya PrasadTromans, Samuel JosephUbah, Chukwudi SUmair, MuhammadUmakanthan, SrikanthUnim, BrigidVaithinathan, Asokan GovindarajValadan Tahbaz, SahelValenti, MarioValizadeh, RohollahVan den Eynde, JefVarthya, Shoban BabuVeroux, MassimilianoVerras, Georgios-IoannisVillani, LeonardoViolante, Francesco SVlassov, VasilyWalde, Mandaras TarikuWang, FangWang, ShuWang, YanqingWang, YanzhongWassie, Emebet GashawWeerakoon, Kosala GayanWolde, Asrat ArjaXu, XiaoyueYadav, VikasYang, LinYano, YuichiroYehualashet, Sisay ShewasinadYi, SiyanYiğit, ArzuYiğit, VahitYip, PaulYonemoto, NaohiroZaki, NazarZamagni, GiuliaZaman, Burhan AbdullahZastrozhin, MichaelZhang, HaijunZhang, YunquanZhang, Zhi-JiangZhao, HanqingZhong, Claire ChenwenZielińska, MagdalenaZuhriyah, LilikHay, Simon INaghavi, MohsenMurray, Christopher J LDandona, RakhiKassebaum, Nicholas JFemaleGestational AgeGlobal Burden of DiseaseGlobal HealthHumansInfant MortalityInfantNewbornPregnancyStillbirthBackground: Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, methodically accounted for different stillbirth definitions with the aim of comprehensively estimating all stillbirths at 20 weeks or longer for 204 countries and territories from 1990 to 2021. Methods: We extracted data on stillbirths from 11 412 sources across 185 of 204 countries and territories, including 234 surveys, 231 published studies, 1633 vital statistics reports, and 10 585 unique location-year combinations from vital registration systems. Our final dataset comprised 11 different definitions, which were adjusted to match two gestational age thresholds: 20 weeks or longer (reference) and 28 weeks or longer (for comparisons). We modelled the ratio of stillbirth rate to neonatal mortality rate with spatiotemporal Gaussian process regression for each location and year, and then used final GBD 2021 assessments of fertility and all-cause neonatal mortality to calculate total stillbirths. Secondary analyses evaluated the number of stillbirths missed with the more restrictive gestational age definition, trends in stillbirths as a function of Socio-demographic Index, and progress in reducing stillbirths relative to neonatal deaths. Findings: In 2021, the global stillbirth rate was 23·0 (95% uncertainty interval [UI] 19·7–27·2) per 1000 births (stillbirths plus livebirths) at 20 weeks' gestation or longer, compared to 16·1 (13·9–19·0) per 1000 births at 28 weeks' gestation or longer. The global neonatal mortality rate in 2021 was 17·1 (14·8–19·9) per 1000 livebirths, corresponding to 2·19 million (1·90–2·55) neonatal deaths. The estimated number of stillbirths occurring at 20 weeks' gestation or longer decreased from 5·08 million (95% UI 4·07–6·35) in 1990 to 3·04 million (2·61–3·62) in 2021, corresponding to a 39·8% (31·8–48·0) reduction, which lagged behind a global improvement in neonatal deaths of 45·6% (36·3–53·1) for the same period (down from 4·03 million [3·86–4·22] neonatal deaths in 1990). Stillbirths in south Asia and sub-Saharan Africa comprised 77·4% (2·35 million of 3·04 million) of the global total, an increase from 60·3% (3·07 million of 5·08 million) in 1990. In 2021, 0·926 million (0·792–1·10) stillbirths, corresponding to 30·5% of the global total (3·04 million), occurred between 20 weeks' gestation and 28 weeks' gestation, with substantial variation at the country level. Interpretation: Despite the gradual global decline in stillbirths between 1990 and 2021, the overall number of stillbirths remains substantially high. Counting all stillbirths is paramount to progress, as nearly a third—close to 1 million in total—are left uncounted at the 28 weeks or longer threshold. Our findings draw attention to the differential progress in reducing stillbirths, with a high burden concentrated in countries with low development status. Scarce data availability and poor data quality constrain our capacity to precisely account for stillbirths in many locations. Addressing inequities in universal maternal health coverage, strengthening the quality of maternal health care, and improving the robustness of data systems are urgently needed to reduce the global burden of stillbirths. Funding: Bill & Melinda Gates Foundation.This project was supported by the Bill & Melinda Gates FoundationElsevier Ltd.2024-12-26T07:55:17Z2024-11-04Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/S0140-6736(24)01925-1Comfort, Haley et al.(2024).Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021, The Lancet, 404(10466), pp. 1955 - 19880140-6736https://www.sciencedirect.com/science/article/pii/S0140673624019251http://hdl.handle.net/10576/620291955 - 1988104664041474-547Xenhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/620292024-12-26T19:08:46Z
spellingShingle	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021 Comfort, Haley Female Gestational Age Global Burden of Disease Global Health Humans Infant Mortality Infant Newborn Pregnancy Stillbirth
status_str	publishedVersion
title	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
title_full	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
title_fullStr	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
title_full_unstemmed	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
title_short	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
title_sort	Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
topic	Female Gestational Age Global Burden of Disease Global Health Humans Infant Mortality Infant Newborn Pregnancy Stillbirth
url	http://dx.doi.org/10.1016/S0140-6736(24)01925-1 https://www.sciencedirect.com/science/article/pii/S0140673624019251 http://hdl.handle.net/10576/62029

Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021

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