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Commentary on european workshop for BJOG revision 20190913.docx (65.73 kB)

Producing valid statistics when legislation, culture, and medical practices differ for births at or before the threshold of survival: Report of a European workshop

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journal contribution
posted on 2020-03-20, 12:21 authored by LK Smith, B Blondel, J Zeitlin, Gerald Haidinger, Sophie Alexander, Rumyana Kolarova, Urelija Rodin, Theopisti Kyprianou, Petr Velebil, Laust Mortensen, Luule Sakkeus, Mika Gissler, Beatrice Blondel, Guenther Heller, Nicholas Lack, Aris Antsaklis, Istvan Berbik, Helga Sol Olafsdottir, Sheelagh Bonham, Marina Cuttini, Janis Misins, Jelena Isakova, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsoyr, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Natasa Tul, Francisco Bolumar, Karin Gottvall, Karin Kallen, Sylvan Berrut, Melanie Riggenbach, Alison Macfarlane, Jennifer Zeitlin, Marie Delnord, Melanie Durox, Ashna Hindori-Mohangoo
Perinatal mortality is a major population health indicator
conveying important signals about the state of maternity
care and measures of the current and future health of
mothers and newborns. International comparisons are used
to encourage countries to improve their perinatal health
and health systems. However, extensive evidence highlights
methodological challenges to ensuring valid and robust
comparisons, as a lack of standardised criteria can lead to
bias and inappropriate inferences.
One major issue is the wide international variation in the criteria for classification and registration of deaths as a stillbirth or neonatal death at the threshold of survival.
Standard practice is to minimise this problem by using a gestational age cut-off of 24 or even 28 weeks for mortality rate calculations. However, this strategy excludes a significant number of stillbirths, at least one in five deaths before 24 weeks of gestation and over one in three deaths before 28 weeks.
As the gestational age limit for initiation of neonatal care decreases, exclusion of these stillbirths limits the full evaluation of
care provision and outcomes at early gestational ages. Fur-
ther, it underestimates the burden of loss on parents’ men-
tal and physical health.

Funding

The Euro‐Peristat project currently receives funding from the European Commission as part of the InfAct (Information for Action) Joint Action (Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) Grant no. 801553).

History

Citation

BJOG: An International Journal of Obstetrics and Gynaecology, February 2020, 127, 3, pp. 314-318

Author affiliation

Department of Health Sciences

Version

  • AM (Accepted Manuscript)

Published in

BJOG: An International Journal of Obstetrics and Gynaecology

Volume

127

Issue

3

Pagination

314-318

Publisher

Wiley

issn

1470-0328

eissn

1471-0528

Acceptance date

2019-09-25

Copyright date

2019

Publisher version

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15971

Spatial coverage

England

Language

English

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