Perinatal death in the Nordic countries in relation to gestational age: The impact of registration practice.

IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2024-11-05 DOI:10.1111/aogs.14950
Maria Jeppegaard, Maria Kongerslev Frølich, Liv Cecilie Vestrheim Thomsen, Anna Heino, Eileen Liu, Johanna Gunnarsdottir, Rupali Rajendra Akerkar, Lene Friis Eskildsen, Karin Källén, Mikael Ohlin, Kari Klungsøyr, Mika Gissler, Lone Krebs
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Abstract

Introduction: Although perinatal death rates in the Nordic countries are among the lowest in the world, the risk of perinatal death is unevenly distributed across the Nordic countries, despite similarity in health care systems and pregnancy care. Birth registration practices across countries may explain some of the differences. We investigated differences in national registration of perinatal mortality within the Nordic countries and its impact on perinatal mortality according to gestational age.

Material and methods: Each country provided information by answering a questionnaire about registration of perinatal deaths. Furthermore, we collected aggregated count data based on Medical Birth Registries (MBR) from all Nordic countries in 2000 to 2021. Perinatal mortality was defined as stillbirth or neonatal death occurring within first 7 days of life. Data were grouped into six groups by gestational age (GA): extremely preterm (>28 + 0 weeks, subdivided into 22 + 0-23 + 6 and 24 + 0-27 + 6), very preterm (GA 28 + 0-31 + 6), moderate preterm (GA 32 + 0-33 + 6), late preterm (GA 34 + 0-36 + 6), term (GA 37 + 0-40 + 6) and late term or post-term birth (GA ≥ 41 + 0). Perinatal mortality rate and risk ratio with 95% confidence intervals were calculated per country for each gestational age group. For Denmark, separate analyses included and excluded induced abortions.

Results: The study included 6 343 805 live births, 22 727 stillbirths and 8932 liveborn infants who died within the first week of life after GA 22 + 0. Further 25 057 births were included with GA < 22 + 0, unknown GA and as a result of induced abortion. Overall, perinatal mortality rates decreased during year 2000-2021 in all Nordic countries. After exclusion of induced abortions, the perinatal mortality rate was similar in the five Nordic countries. The perinatal mortality rate for extremely preterm born infants was highest in Denmark, whereas the highest rate among infants born late term/post-term was in Sweden.

Conclusions: The perinatal mortality rate in the Nordic countries is still decreasing, especially in the group of extremely preterm born infants. This study supports the need for further standardization of birth registration practices to ensure the validity of international comparisons.

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北欧国家围产期死亡与胎龄的关系:登记做法的影响。
导言:尽管北欧国家的围产期死亡率是世界上最低的国家之一,但尽管医疗保健系统和孕期保健相似,围产期死亡风险在北欧国家的分布却不均衡。各国的出生登记做法可能是造成这种差异的部分原因。我们调查了北欧国家围产期死亡登记的差异及其对孕龄围产期死亡率的影响:每个国家都通过回答有关围产期死亡登记的调查问卷来提供信息。此外,我们还收集了 2000 年至 2021 年所有北欧国家基于出生医学登记(MBR)的汇总计数数据。围产期死亡定义为死产或新生儿出生后 7 天内死亡。数据按胎龄(GA)分为六组:极早产(>28 + 0 周,细分为 22 + 0-23 + 6 和 24 + 0-27 + 6)、极早产(GA 28 + 0-31 + 6)、中度早产(GA 32 + 0-33 + 6)、晚期早产(GA 34 + 0-36 + 6)、足月产(GA 37 + 0-40 + 6)和晚期或足月产后(GA ≥ 41 + 0)。每个国家计算了每个胎龄组的围产期死亡率和风险比,以及 95% 的置信区间。对于丹麦,分别进行了包括和不包括人工流产的分析:该研究包括 6 343 805 例活产、22 727 例死胎和 8932 例在胎龄 22+0 后出生一周内死亡的活产婴儿。此外,还包括胎龄小于 22+0 的 25 057 例新生儿、胎龄未知的新生儿以及因人工流产而死亡的新生儿。总体而言,2000-2021年间,所有北欧国家的围产期死亡率均有所下降。剔除人工流产后,五个北欧国家的围产期死亡率相似。丹麦极早产儿的围产期死亡率最高,而瑞典晚产/过期产儿的围产期死亡率最高:结论:北欧国家的围产期死亡率仍在下降,尤其是极早产儿。这项研究支持了进一步规范出生登记做法的必要性,以确保国际比较的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.00
自引率
4.70%
发文量
180
审稿时长
3-6 weeks
期刊介绍: Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical, basic and translational research work related to all aspects of women’s health from around the globe. The journal regularly publishes commentaries, reviews, and original articles on a wide variety of topics including: gynecology, pregnancy, birth, female urology, gynecologic oncology, fertility and reproductive biology.
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