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      Stillbirths: economic and psychosocial consequences.

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          Abstract

          Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.

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          Author and article information

          Journal
          Lancet
          Lancet (London, England)
          1474-547X
          0140-6736
          Feb 6 2016
          : 387
          : 10018
          Affiliations
          [1 ] Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK; St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; International Stillbirth Alliance, New York, NY, USA. Electronic address: alexander.heazell@manchester.ac.uk.
          [2 ] International Stillbirth Alliance, New York, NY, USA; Academic Centre for Women's Health, University of Bristol, Bristol, UK; Southmead Hospital, Bristol, UK.
          [3 ] Centre for Maternal Reproductive and Child Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
          [4 ] Academic Centre for Women's Health, University of Bristol, Bristol, UK; Southmead Hospital, Bristol, UK.
          [5 ] Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
          [6 ] Arizona State University, Tempe, AZ, USA.
          [7 ] Institute for Reproductive and Family Health, Hanoi Vinmec International General Hospital, Hanoi, Vietnam.
          [8 ] Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
          [9 ] International Stillbirth Alliance, New York, NY, USA; Mater Research Institute, University of Queensland, Brisbane, QLD, Australia.
          [10 ] International Stillbirth Alliance, New York, NY, USA; Department of Family Medicine and Department of Obstetrics, University of Michigan, Ann Arbor, MI, USA.
          [11 ] Krachi Midwifery Training School, Kete-Krach, Ghana.
          [12 ] Clinical Center Department of Bioethics, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
          [13 ] Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland.
          [14 ] National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
          [15 ] Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
          [16 ] Wellbeing Foundation Africa, Lagos, Nigeria.
          [17 ] International Stillbirth Alliance, New York, NY, USA.
          [18 ] ReaCH group, University of Central Lancashire, Preston, UK.
          Article
          S0140-6736(15)00836-3
          10.1016/S0140-6736(15)00836-3
          26794073
          d134b3b3-c4b8-479c-a09d-81ae729ee8ea
          Copyright © 2016 Elsevier Ltd. All rights reserved.
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