Steigende Totgeburtenraten in Deutschland: Eine Analyse der Veränderungen der Alters- und Nationalitätsstruktur von Gebärenden von 2009–2018

Background:
Stillbirth rates in Germany have been increasing steadily after reaching a low in 2007. Previous studies could not explain the underlying reasons. This study examines whether structural changes in population composition in terms of age and nationality of those giving birth contributed to the increasing stillbirth rates in Germany.

Methods:
The stillbirth rate increase is decomposed into the effect of changing population structures and the effect of the change in mortality.

Results:
Increasing stillbirth rates can be observed across all age groups, except among those aged under 20, and for all nationality groups. Changes in nationality- and age structures of people giving birth contributed only marginally to the observed increase. The trend is primarily driven by increasing mortality across all groups.

Conclusion:
Compositional changes of people giving birth can be excluded as a main driver of the increased stillbirth rate in Germany since 2007. Instead, prenatal mortality has increased in all groups. Follow-up studies, which examine the causes of this trend, in particular whether and to what extent it is related to changes in prenatal and perinatal health care provision in Germany, are urgently needed.