Modern view of the causes of antenatal fetal death

About two million cases of prenatal fetal death are recorded annually, that is, a stillborn baby is born every 16 seconds. However, even such impressive data does not reflect the full scale of the problem. The WHO data does not include stillbirth rates at 22–28 weeks, which some studies estimate would increase the rate by about 40%. The difference in stillbirth rates in developed and developing countries indicates the quality of medical care and, as a result, the country’s medical system. According to the Federal State Statistics Service, the stillbirth rate in the Russian Federation accounts for a large share of perinatal loss (79%) and does not have a downward trend. Besides, there is currently no unified classification of the causes of prenatal fetal death, which complicates the analysis of stillbirth cases and possible reserves for their reduction. It is noteworthy that the proportion of cases with an unknown cause of perinatal mortality is growing (3.1% in 2019 and 4.7% in 2020). Despite the fact that the rate of unexplained causes of antenatal fetal death in the Russian Federation is almost three times lower than abroad, the large proportion of causes associated with fetal asphyxia deprives these data of specificity. Against the backdrop of the demographic crisis in the Russian Federation (the birth rate for 2022 was 1.4), identifying risk factors for antenatal fetal death is especially acute, since this underlies the creation of preventive measures to reduce the risk of adverse obstetric outcomes.