How do late terminations of pregnancy affect comparisons of stillbirth rates in Europe? Analyses of aggregated routine data from the Euro-Peristat Project

B. Blondel, M. Cuttini, A. D. Hindori-Mohangoo, M. Gissler, M. Loghi, C. Prunet, A. Heino, L. Smith, K. van der Pal-de Bruin, A. Macfarlane, J. Zeitlin, Gerald Haidinger, Sophie Alexander, Pavlos Pavlou, Petr Velebil, Laust Hvas Mortensen, Luule Sakkeus, Nicholas Lack, Aris Antsaklis, István BerbikHelga Sól Ólafsdóttir, Sheelagh Bonham, Janis Misins, Jone Jaselioniene, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsoyr, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Nataša Tul, Francisco Bolúmar, Karin Gottvall, Sylvie Berrut, the Euro-Peristat Scientific Committee

Research output: Contribution to journalArticle

Abstract

Objective: To describe how terminations of pregnancy at gestational ages at or above the limit for stillbirth registration are recorded in routine statistics and to assess their impact on comparability of stillbirth rates in Europe. Design: Analysis of aggregated data from the Euro-Peristat project. Setting: Twenty-nine European countries. Population: Births and late terminations in 2010. Methods: Assessment of terminations as a proportion of stillbirths and derivation of stillbirth rates including and excluding terminations. Main outcome measures: Stillbirth rates overall and excluding terminations. Results: In 23 countries, it is possible to assess the contribution of terminations to stillbirth rates either because terminations are rare occurrences or because they can be distinguished from spontaneous stillbirths. Where terminations were reported, they accounted for less than 1.5% of stillbirths at 22+ weeks in Denmark, between 13 and 22% in Germany, Italy, Hungary, Finland and Switzerland, and 39% in France. Proportions were much lower at 24+ weeks, with the exception of Switzerland (7.4%) and France (39.2%). Conclusions: Terminations represent a substantial proportion of stillbirths at 22+ weeks of gestation in some countries. Countries where terminations occur at 22+ weeks should publish rates with and without terminations in order to improve international comparisons and the policy relevance of stillbirth statistics. Tweetable abstract: For valid comparisons of stillbirth rates, data about late terminations of pregnancy are needed.

Original languageEnglish
Pages (from-to)226-234
Number of pages9
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume125
Issue number2
DOIs
Publication statusE-pub ahead of print - May 30 2017

Keywords

  • Euro-Peristat
  • international comparisons
  • pregnancy terminations
  • registration
  • stillbirth

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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    Blondel, B., Cuttini, M., Hindori-Mohangoo, A. D., Gissler, M., Loghi, M., Prunet, C., Heino, A., Smith, L., van der Pal-de Bruin, K., Macfarlane, A., Zeitlin, J., Haidinger, G., Alexander, S., Pavlou, P., Velebil, P., Mortensen, L. H., Sakkeus, L., Lack, N., Antsaklis, A., ... the Euro-Peristat Scientific Committee (2017). How do late terminations of pregnancy affect comparisons of stillbirth rates in Europe? Analyses of aggregated routine data from the Euro-Peristat Project. BJOG: An International Journal of Obstetrics and Gynaecology, 125(2), 226-234. https://doi.org/10.1111/1471-0528.14767