Stillbirth remains a major public health challenge in sub-Saharan Africa, yet data on how often it occurs and why it happens remain limited. Through the PREgnancy Care Integrating translational Science, Everywhere (PRECISE) cohort study, researchers are generating new evidence to better understand stillbirth and identify opportunities for prevention.

The PRECISE Network analysed birth outcomes from 5,772 women aged 16–49 years enrolled across seven health facilities in Kenya, Mozambique, and The Gambia between 2019 and 2022. The study found an overall stillbirth rate of 29.2 per 1,000 births—around three in every 100 pregnancies—although rates varied across countries.

Nearly 90% of stillbirths occurred at 28 weeks of pregnancy or later. However, the study also highlighted the importance of recognising earlier losses. Dr Hannah Blencowe, a maternal, perinatal and child health researcher at the London School of Hygiene & Tropical Medicine (LSHTM), said:

“Almost 11% of stillbirths occurred between 20 and 27 weeks: losses that would be invisible under the standard 28-week reporting threshold. To end preventable stillbirths, health systems must prioritise equitable access to evidence-based care, including better management of hypertension, antepartum haemorrhage, and dedicated support for women with a previous stillbirth.”

The study identified several factors associated with increased risk of stillbirth, including a previous stillbirth, severe high blood pressure during pregnancy, bleeding before delivery, caesarean delivery, and babies who were smaller than expected for their stage of pregnancy.

The findings show that stillbirth is influenced by multiple and interconnected factors. Preventing avoidable losses will require stronger antenatal and maternity care systems that support early identification of risk, timely referral, and access to high-quality emergency obstetric care.

Prof. Peter von Dadelszen, Principal Investigator of the PRECISE Network at King’s College London, said:

“As an obstetrician, I understand the tragedy of stillbirth—what should have been a time of hope and joy is transformed into one of tragedy, isolation and, in some societies, alienation. By identifying risk factors that precede these tragic events, we provide opportunities for women and families, and the health systems designed to support them, to respond.”

Through the PRECISE Network, researchers across Africa and globally are working to generate the evidence needed to improve pregnancy care and reduce preventable stillbirths.

Mwashigadi G., Akuze J., Koech A., Jah H., Roca A., D’Alessandro U., Sevene E., Maculuve S., Valá A., Singh S., Atkins B., Omuse G., Mukhanya M., Volvert M.-L., Magee L., Craik R., Temmerman M., von Dadelszen P., Blencowe H., PRECISE Network. Incidence and risk factors for stillbirth in Kenya, Mozambique and the Gambia: the PRECISE cohort study Lancet Regional health Africa

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