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

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023698%3A_____%2F20%3AN0000005" target="_blank" >RIV/00023698:_____/20:N0000005 - isvavai.cz</a>

Result on the web

<a href="https://doi.org/10.1111/1471-0528.15971" target="_blank" >https://doi.org/10.1111/1471-0528.15971</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/1471-0528.15971" target="_blank" >10.1111/1471-0528.15971</a>

Result language

angličtina

Original language name

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

Original language description

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.1 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.2-5 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.6 As the gestational age limit for initiation of neonatal care decreases,7 exclusion of these stillbirths limits the full evaluation of care provision and outcomes at early gestational ages. Further, it underestimates the burden of loss on parents' mental and physical health.8, 9 To identify ways to improve the comparability of data on early gestational age births, a workshop was held in Kerkrade, the Netherlands (April 2018), by the Euro-Peristat network.10 This European collaboration of 31 countries was set up to monitor perinatal health internationally by developing a list of valid and reliable indicators. Workshop participants comprised statisticians from national birth and death registers, obstetricians, midwives, neonatologists, epidemiologists, and population health researchers (Appendix S1). Discussion in small groups about national practices was structured around clinical scenarios to raise awareness about how legal requirements and clinical management affect registration and recording of deaths. Scenarios focused on antepartum death and preterm rupture of membranes, and explored the impact of multiple pregnancy, termination of pregnancy, induction of labour, and assessment of signs of life on recorded outcomes (Box S1). Results of the discussions were synthesised through a plenary presentation and participants provided comments on a written summary of the findings. This commentary summarises the workshop discussion and makes recommendations for the reporting of births at the threshold of survival in Europe (Box 1) in light of the 2015 Canadian Consensus Conference, which explored improving fetal death registration procedures.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30214 - Obstetrics and gynaecology

Project

—

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2020

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

BJOG: An International Journal of Obstetrics & Gynaecology

ISSN

1470-0328

e-ISSN

1471-0528

Volume of the periodical

127

Issue of the periodical within the volume

3

Country of publishing house

GB - UNITED KINGDOM

Number of pages

5

Pages from-to

314-318

UT code for WoS article

000494733400001

EID of the result in the Scopus database

2-s2.0-85075172123