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Data set notes

European Health for All database

Indicators: 565

Updated: 18 October 2024

Contact: Data and Digital Health Unit (DDH)

The following abbreviations are used in the indicator titles:

• SDR: age-standardized death rates (see HFA-DB user manual/Technical notes, page 13, for details)

• FTE: full-time equivalent

• PP: physical persons

• PPP$: purchasing power parities expressed in US $, an internationally comparable scale reflecting the relative domestic purchasing powers of currencies.

More information: http://www.euro.who.int/en/data-and-evidence/databases/european-health-for-all-database-hfa-db

Indicator notes

Number of dead-born fetuses
Indicator code: E075402.T

Fetal death is death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. This data item is used to calculate the fetal death rate and includes fetal deaths according to national criteria (preferably with weight 500 g or more). See ICD-9/10 manual for details. (Data are received from countries for HFA monitoring purposes or extracted from national statistical yearbooks.) Fetal death rate: (Fetal deaths*1000)/(total births)._

Country/Area notes

Albania

INSTAT.

Armenia

Source of data: National Health Information Analytic Center, Ministry of Health of the Republic of
Armenia http://moh.am/?section=static_pages/index&id=625&subID=824,29
Data collected annually, reference period: 31 December.
Breaks in time series: 1985. and 2005 Before 1985 data was collected without information about dead
born foetuses? weight. From 1985 weight became a mandatory requirement in the amended reporting form
of the MoH ?Report on medical care for pregnant women, women in labor and puerperants?.
Starting from 2005 featuses born with weight 500g+ are included in live birth and stillbirth
statistics, after the introduction of the revised version of ICD-10 in the country.

Azerbaijan

Up to 2010, deaths up to 20 weeks and 500 grams were registered as abortions or immature births.
From 2010 these are registered as dead born foetuses.

Belgium

Source: Statistics Belgium (National Institute for Statistics). The increase registered since 2008
is due to a better registration of cases between 22 weeks and 180 days.

Bosnia and Herzegovina

See Indicator 075001.

Bulgaria

Up to 2008 data refers to stillborns with a body weight of 1000-2499 g. From 2008 the data includes
stillborns with a body weight over 1000 g.

Croatia

Under national criteria only foetuses born dead after 28 completed weeks of gestation are included,
as birth weight data are not available from vital statistics.
The number of dead born foetuses for 1998 includes cases where mothers are residents of the Republic
of Croatia if they were not absent from Croatia longer than one year or those who were not residents
but have lived in Croatia one year or more.

Cyprus

The data referring to stillbirths for the years 2011-2013 are derived from the death certificates
collected by Health Monitoring Unit. For the year 2014 the data for stillbirths are derived from the
Birth Registry of Health Monitoring Unit and are still preliminary. Included are the dead born
fetuses referring to non-residents.

Czechia

Source: Czech Statistical Office (CZSO). National criteria:
Till March 2012: only fetuses with a weight of 1000 g or more are included
Since April 2012: fetuses with a weight of 500 g or more are included

Denmark

1973 - 2003: all dead-born fetuses born after 28 weeks of pregnancy are included.
2004 - : dead-born fetuses born after 22 weeks of pregnancy are included.
Note: In 2006 the number of dead born fetuses might be underestimated.
Source: The Medical Birth Registry, The Danish Health Data Authority.

Estonia

Source: Statistical Office of Estonia.
From 1992 includes weight of 500+ grams. Before 1992 includes weight of 1000+ grams.

Finland

Source: Medical Birth Register (MBR), THL (National Institute for Health and Welfare).
Note: From 1987 the MBR data was updated to remove the cases which are born abroad and to include
foreigners not permanently living in Finland (excluded in the data from Vital Statistics Finland).

France

Before 2001 the data include stillborns of up to 28 weeks of pregnancy. From 2002-2008 the cases
meet WHO criteria (weight >500 grams or 22 weeks of pregnancy). From 2008, the criteria of weight or
duration of pregnancy is no longer necessary in order to issue a certificate. The data are not
comparable with other countries. The search for a solution is in progress.

Georgia

Source: National Centre for Disease Control and Public Health of Georgia (NCDC)
(http://www.ncdc.ge).

Germany

Source: Federal Statistical Office, Statistics on the natural movement of the population, Fachserie
1, Reihe 1.1.
http://www.destatis.de or http://www.gbe-bund.de
Break in time series: In 1994 the definition of stillborn changed. Since April 1994, only children
with a weight at birth of at least 500 g have been registered as stillbirths. Before 1994, a birth
weight of 1000g was used. Miscarriages (since April 1994, less than 500 g weight at birth,
previously from July 1979, less than 1,000 g weight at birth) are not recorded by the registrars and
are not considered. Therefore, the years prior to 1995 are not comparable with the years from 1995
onwards.

Greece

Includes dead-born fetuses of weight above 500 grams.

Hungary

Source: Yearbooks of Demographic and Health Statistics of the Hungarian Central Statistical Office
(KSH).

Iceland

Source: The Icelandic Birth Registration.
Stillborn >=22 weeks, or 500 g if duration of pregnancy is unknown. Close to 100% of women undergo
an ultrasound scan at 20 weeks and therefore duration of pregnancy is almost always known.

Ireland

Source: National Perinatal Reporting System. Figures for the 2014 are provisional. Up to 2004 the
source was Central Statistics Office.
Break in time series: Up to 2004, figures are registration data and refer to the death of a foetus
weighing 500 grams or more or at a gestational age of 24 weeks or more. Prior to 1995 figures refer
to the death of a foetus at, or over, 28 weeks gestation.

Israel

The data include cases with birth weight of 500g or more, or when the birth weight is unknown, cases
with 22 weeks or more of gestation age. Since 1999 data have improved due to an increased level of
reporting.
Source: Statistical Abstract of Israel, Central Bureau of Statistics.Since 2005, Mother, Child &
Adolescent Department, Ministry of Health.

Italy

Source: ISTAT until 2002. Source from 2003: Ministry of Health, Health Information System, Delivery
Certificates Database. Coverage in 2003: 84% of deliveries, recorded in National Database of
Hospital Discharges. In 2004, 86% of deliveries recorded in National Database of Hospital
Discharges. Coverage in 2005: 92% of deliveries, recorded in National Database of Hospital
Discharges in the same year. Coverage in 2006: 92.9% of deliveries, recorded in National Database of
Hospital Discharges in the same year. Coverage in 2007: 93.0% of deliveries, recorded in National
Database of Hospital Discharges in the same year. Coverage in 2008: 96.6% of deliveries, recorded in
National Database of Hospital Discharges in the same year. Coverage in 2009: 98.2% of deliveries,
recorded in National Database of Hospital Discharges in the same year. Coverage in 2010: 98,8% of
deliveries, recorded in National Database of Hospital Discharges in the same year. Coverage in 2011:
98.8% of deliveries, recorded in National Database of Hospital Discharges in the same year. Coverage
in 2012: 99.9% of deliveries, recorded in National Database of Hospital Discharges in the same year.
Coverage in 2013: 100.3% of deliveries, recorded in National Database of Hospital Discharges in the
same year. The number of live births registered in the Delivery Certificates Database in 2013 is:
510.659.

Kazakhstan

Break in time series: 2008, when live birth and stillbirth criteria, recommended by the World Health
Organization, were introduce in the country.

Latvia

Break in time series: Starting from 1991, the official data involves births with duration of
pregnancy of at least 22 weeks (or birth weight 500 grams). The statistics until 1990 include only
births with birth weight 1000 grams or more.

Lithuania

Source: Central Statistical Office.

Luxembourg

Source: Direction de la Sante Service des Statistiques.
Definition: all dead born foetuses are included, even those of less than 500 g and those of unknown
weight at birth.

Malta

Source: Department of Health Information and Research (National Mortality Register).

Montenegro

Data from 2010 to 2014 are not presented, and additional checking is needed because of the changes
in the system of collecting and reporting the data of vital and mortality statistics.

Netherlands

Source from 2004: The Netherlands Perinatal Registry (PRN). Includes the number of births after a
gestational age of 22 weeks or more.
The number of dead born foetuses, is derived from the linkage of PRN-data and Population Register
(PR).
Break in time series: until 2004 the source was Statistics Netherlands: Cause of death statistics.
Includes stillbirths born after a gestational age of 24 weeks or more.

North Macedonia

Source: State Statistical Office (SSO).

Norway

Includes data for 16+ weeks and 500+ grams.

Poland

Source of data: Central Statistical Office.

Portugal

Source of data: National Statistical Institute Coverage: National

Republic of Moldova

This indicator is calculated as follows: (Number of stillbirths * 1000) / Births living and the
dead.
Source of data: Medical certificate of perinatal death.

Serbia

Still births refer to a fetus over 28 weeks of gestation which shows no evidence of life after
spontaneous separation or extraction from the mother's body.
Source of data: National Statistical Office.
Coverage: from 1998 onwards data do not cover Kosovo and Metohija Province that is under the interim
civilian and military administration of the UN.

Slovakia

Source: Statistical Office of the Slovak Republic

Slovenia

Source of data: National Institute of Public Health, Slovenia (NIJZ)Deviation from the definition:
In case of multiple pregnancies, if one of the newborns is born alive, we count between fetal deaths
also the stillborn pair, even if weighing less than 500 grams.

Spain

The number of dead born foetuses provided is with weight 500 g or more. If weight data is not
available, the second decision criteria is to provide dead born foetuses with 22 weeks of gestation
or more.
Source: National Statistics Institute, extracted from ?Demographic Phenomena. Late fetal death
statistcs?
http://www.ine.es/jaxi/menu.do?type=pcaxis&path=%2Ft20%2Fe304&file=inebase&L=&L=1

Sweden

Source of data: The National Board of Health and Welfare (NBHW)
The Medical Birth Register (NBHW)
The Causes of Death Register (NBHW)
http://www.socialstyrelsen.se/english

The time series has been updated (2016-04-18) for all available years from MFR (1973-2014), data for
1970-1972 is missing and data for 2015 is not available.
There are also stillborn with weight less than 500 grams in Swedish Medical Birth Register. For many
years was minimum weight 300 g, but for two years ago the minimum weight changed to 270 g.
The definition of stillbirth in Sweden:
In Sweden defines stillbirth (fetal death in utero) as the birth of a child without signs of life
with a gestational age of less than 28 completed weeks. Since 1 July 2008, even children born after
at least 22 complete weeks included. The number of stillbirths reported per 1 000 live births.

Switzerland

Source of data: FSO Federal Statistical Office, BEVNAT
http://www.bfs.admin.ch/bfs/portal/fr/index/infothek/erhebungen__quellen/blank/blank/bevnat/01.html
Coverage:
Deviation from the definition: Until 2004, the definition of fetal death was a fetus with a size
from at least 30cm. Since 2005, minimal gestation period of 22 weeks or minimal fetal weight of 500g

Türkiye

Source of data: Public Health Institution of Turkey, Ministry of Health of Turkey.

Turkmenistan

Source of data: Administrative medical statistics, form 19 ?Report on medical care for pregnant
women, women in labour and puerperant?, and form 14 ?Report on hospital activity?, form 096/y
?Journal of labour?, ?Medical certificate of perinatal death? 0106-2/y.

Ukraine

Source: Centre of Health Statistics, Ministry of Health.
Coverage: Includes only dead born foetuses 500+ g registered at institutions under the Ministry of
Health.

United Kingdom

Source of Data: England and Wales - Office for National Statistics VS1 table;
Scotland - General Register Office for Scotland - number of stillbirths registered during the
calendar year. Up to 30 September 1992 the definition includes pregnancies after 28 weeks. From
October 1992 then period is from 24 weeks of pregnancy.
Northern Ireland - Statistics and research Agency.
The number of still births registered during the calendar year
The Stillbirth (Definition) Act 1992 redefined a stillbirth, from 1 October 1992, as a child which
had issued forth from its mother after the 24th week of pregnancy and which did not breath or show
any other sign of life. Prior to 1 October 1992 the statistics related to events occurring after the
28th week of pregnancy.

General notes

Understanding the Number of Dead-born Fetuses

The indicator "Number of Dead-born Fetuses" provides critical insights into the health outcomes of pregnancies within a population. This measure is not merely a statistic; it serves as a vital health indicator that reflects the effectiveness of prenatal and perinatal care, as well as the overall health environment of a society. By tracking the number of fetuses that do not survive to birth, health professionals and policymakers can assess and improve maternal and child health services. This data is essential for identifying public health priorities and allocating resources effectively to reduce fetal mortality rates and enhance maternal health.

The Importance of Monitoring Dead-born Fetuses

Tracking the number of dead-born fetuses is crucial for understanding and improving maternal and fetal health. This data helps identify risk factors associated with fetal mortality, including maternal health conditions, access to prenatal care, and socioeconomic factors. By understanding these patterns, health authorities can implement targeted interventions to reduce preventable deaths and improve health outcomes. Additionally, this indicator is essential for international health comparisons, providing a benchmark for evaluating health services and outcomes globally.

Strengths and Limitations of the Dead-born Fetuses Indicator

While the data on dead-born fetuses is invaluable for health monitoring and planning, it comes with its own set of strengths and limitations.

Strengths

This indicator is a critical measure for assessing the quality of maternal and child health services. It allows for consistent tracking and comparison across different geographical and temporal scales, facilitating global health studies and interventions. The data helps in resource allocation, guiding health authorities to prioritize areas with higher rates of fetal mortality. Furthermore, it aids in evaluating the impact of health policies and programs, providing a clear metric to measure progress towards improving maternal and child health.

Limitations

However, the reliability of this indicator heavily depends on the quality of data collection and reporting systems. In regions with underdeveloped health infrastructure, data on dead-born fetuses may be incomplete or inaccurate, leading to potential misrepresentation of the actual situation. Moreover, this indicator does not account for the causes of fetal deaths, which are crucial for developing specific health interventions. The lack of detailed data limits the ability to address the underlying factors effectively. Additionally, cultural and societal factors may influence reporting practices, further complicating the accurate assessment of fetal mortality rates.

In conclusion, while the "Number of Dead-born Fetuses" is a fundamental health indicator with significant implications for public health, it must be interpreted with an understanding of its potential limitations. Continuous efforts to improve data accuracy and completeness are essential for utilizing this indicator to its fullest potential in enhancing maternal and child health globally.