The economic burden associated with stillbirth: A systematic review

Abstract

Background Evidence on the economic burden of stillbirth is limited. In this systematic review, we aimed to identify studies focusing on the economic burden of stillbirth, describe the methods used, and summarize the findings. Method We performed a systematic search in Medline, EMBASE, Cochrane library, and EconLit from inception to July 2021. Original studies reporting the cost of illness, economic burden, or health care expenditures related to stillbirth were included. Two reviewers independently extracted data and evaluated study quality using the Larg and Moss checklist. A narrative synthesis was performed. Costs were presented in US dollars (US$) in 2020. Results From the 602 records identified, a total of four studies were included. Eligible studies were from high‐income countries. Only one study estimated both direct and indirect costs. Among three cost‐of‐illness studies, two studies undertook a prevalence‐based approach. The quality of these studies varied and was substantially under‐reported. Four studies describing direct costs ranged from $6934 to $9220 per stillbirth. Indirect costs account for around 97% of overall costs. No studies have incorporated intangible cost components. Conclusions The economic burden of stillbirth has been underestimated and not extensively studied. There are no data on the cost of stillbirth from countries that bear a higher burden of stillbirth. Extensive variation in methodologies and cost components was observed in the studies reviewed. Future research should incorporate all costs, including intangible costs, to provide a comprehensive picture of the true economic impact of stillbirth on society.

Disease and Economic Burden of Stillbirths in India in 2019

“…Previous work has focused on assessing the economic burden of stillbirths in high-income countries (HICs). 4 However, the study presents no value for India. The study encompasses a review of four studies based in the United Kingdom, the United States, and Australia.…”

“…Previously, cost-of-illness assessments that investigate direct and indirect costs have noted that stillbirths can cost families anywhere between 10% and 70% greater than a live birth. 4 However, the economic burden of stillbirth is often underestimated and the literature is scant. 5 Another approach to comprehensively assess economic burden is known as the value of life-year (VLY) or full-income approach.…”