The prevalence of stillbirths: a systematic review

BACKGROUND: Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Obtaining overall estimates across various regions of the world is not straightforward due to variation in definitions, data collection methods and reporting. METHODS: We conducted a systematic review of a range of pregnancy-related conditions including stillbirths and performed meta-analysis of the subset of studies reporting stillbirth rates. We examined variation across rates and used meta-regression techniques to explain observed variation. RESULTS: We identified 389 articles on stillbirth prevalence among the 2580 included in the systematic review. We included 70 providing 80 data sets from 50 countries in the meta-analysis. Pooled prevalence rates show variation across various subgroup categories. Rates per 100 births are higher in studies conducted in less developed country settings as compared to more developed (1.17 versus 0.50), of inadequate quality as compared to adequate (1.12 versus 0.66), using sub-national sample as compared to national (1.38 versus 0.68), reporting all stillbirths as compared to late stillbirths (0.95 versus 0.63), published in non-English as compared to English (0.91 versus 0.59) and as journal articles as compared to non-journal (1.37 versus 0.67). The results of the meta-regression show the significance of two predictor variables – development status of the setting and study quality – on stillbirth prevalence. CONCLUSION: Stillbirth prevalence at the community level is typically less than 1% in more developed parts of the world and could exceed 3% in less developed regions. Regular reviews of stillbirth rates in appropriately designed and reported studies are useful in monitoring the adequacy of care. Systematic reviews of prevalence studies are helpful in explaining sources of variation across rates. Exploring these methodological issues will lead to improved standards for assessing the burden of reproductive ill-health

Marine invasion genomics: Revealing ecological and evolutionary consequences of biological invasions

Genomic approaches are increasingly being used to study biological invasions. Here, we first analyse how high-throughput sequencing has aided our understanding of the mechanisms associated with biological invasions. These include the transport of propagules to pre-invaded areas, an exploration of the consequences of hybridisation during range expansions, and the pre- and post- invasion adaptation of colonising populations. We then explore how contemporary genomic methods have been used to probe and monitor the spread of non-indigenous species. More specifically, we focus on the detection of species richness from environmental samples, measures of quantitative traits that may promote invasive- ness, analysis of rapid adaptation, and the study of phenotypic plasticity. Finally, we look to the future, exploring how genomic approaches will assist future biodiversity conservationists in their efforts to mitigate the spread and effects of biological invasions. Ultimately, although the use of genomic tools to study non-indigenous species has so far been rather limited, studies to date indicate that genomic tools offer unparalleled research opportunities to continually improve our understanding of marine biological invasion