OBJECTIVES: Stillbirth is uncommon, yet it has a significant impact on families and society. The consequences are frequently underestimated and overlooked. Evidence on the economic burden of stillbirth is limited. This review aims to systematically identify studies estimating economic burden of stillbirth, describe the methods used, and summarize the findings of the economic burden.

METHODS: We searched Medline, EMBASE, Cochrane library, and Econlit for original articles reporting costs associated with stillbirth published from inception to July 2021. Data were independently extracted by two reviewers. The quality of the studies was assessed using the Larg and Moss checklist. Costs were presented in US dollars (US$) in 2020.

RESULTS: From 602 records identified, a total of 4 studies were included. All of the included studies were from high-income countries including UK, USA, and Australia. Only one study (25%) used a societal perspective estimating both direct and indirect costs. Among three cost-of-illness studies (75%), two studies undertook a prevalence-based approach. The quality of the cost of illness studies was varied and substantially under-reported. Four studies describing direct costs ranged from $6,934 to $9,220 per stillbirth. According to one study, 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.