International Comparisons of Fetal and Neonatal Mortality Rates in High-Income Countries: Should Exclusion Thresholds Be Based on Birth Weight or Gestational Age?

Ashna D. Mohangoo, Béatrice Blondel, Mika Gissler, Petr Velebil, Alison Macfarlane, Jennifer Zeitlin, Gerald Haidinger, Sophie Alexander, Pavlos Pavlou, Petr Velebil, Jens Langhoff Roos, Luule Sakkeus, Mika Gissler, Béatrice Blondel, Nicholas Lack, Aris Antsaklis, István Berbik, Sheelagh Bonham, Marina Cuttini, Janis MisinsJone Jaselioniene, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsoyr, Katarzyna Szamotulska, Henrique Barros, Mária Chmelová, Živa Novak-Antolic, Francisco Bolúmar, Karin Gottvall, Alison Macfarlane

Research output: Contribution to journalArticle

Abstract

Background:Fetal and neonatal mortality rates are essential indicators of population health, but variations in recording of births and deaths at the limits of viability compromises international comparisons. The World Health Organization recommends comparing rates after exclusion of births with a birth weight less than 1000 grams, but many analyses of perinatal outcomes are based on gestational age. We compared the effects of using a 1000-gram birth weight or a 28-week gestational age threshold on reported rates of fetal and neonatal mortality in Europe.Methods:Aggregated data from 2004 on births and deaths tabulated by birth weight and gestational age from 29 European countries/regions participating in the Euro-Peristat project were used to compute fetal and neonatal mortality rates using cut-offs of 1000-grams and 28-weeks (2.8 million total births). We measured differences in rates between and within countries using the Wilcoxon signed rank test and 95% confidence intervals, respectively.Principal Findings:For fetal mortality, rates based on gestational age were significantly higher than those based on birth weight (p

Original languageEnglish
Article numbere64869
JournalPLoS One
Volume8
Issue number5
DOIs
Publication statusPublished - May 20 2013

    Fingerprint

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Mohangoo, A. D., Blondel, B., Gissler, M., Velebil, P., Macfarlane, A., Zeitlin, J., Haidinger, G., Alexander, S., Pavlou, P., Velebil, P., Roos, J. L., Sakkeus, L., Gissler, M., Blondel, B., Lack, N., Antsaklis, A., Berbik, I., Bonham, S., Cuttini, M., ... Macfarlane, A. (2013). International Comparisons of Fetal and Neonatal Mortality Rates in High-Income Countries: Should Exclusion Thresholds Be Based on Birth Weight or Gestational Age? PLoS One, 8(5), [e64869]. https://doi.org/10.1371/journal.pone.0064869