TY - JOUR
T1 - Variations in very preterm birth rates in 30 high-income countries
T2 - are valid international comparisons possible using routine data?
AU - the Euro-Peristat Scientific Committee
AU - Delnord, M.
AU - Hindori-Mohangoo, A. D.
AU - Smith, L. K.
AU - Szamotulska, K.
AU - Richards, J. L.
AU - Deb-Rinker, P.
AU - Rouleau, J.
AU - Velebil, P.
AU - Zile, I.
AU - Sakkeus, L.
AU - Gissler, M.
AU - Morisaki, N.
AU - Dolan, S. M.
AU - Kramer, M. R.
AU - Kramer, M. S.
AU - Zeitlin, J.
AU - Haidinger, Gerald
AU - Alexander, Sophie
AU - Pavlou, Pavlos
AU - Mortensen, Laust
AU - Blondel, Béatrice
AU - Lack, Nicholas
AU - Antsaklis, Aris
AU - Berbik, István
AU - Ólafsdóttir, Helga Sól
AU - Bonham, Sheelagh
AU - Cuttini, Marina
AU - Misins, Janis
AU - Jaselioniene, Jone
AU - Wagener, Yolande
AU - Gatt, Miriam
AU - Nijhuis, Jan
AU - Klungsoyr, Kari
AU - Barros, Henrique
AU - Horga, Mihai
AU - Cap, Jan
AU - Mandić, Natasa Tul
AU - Bolúmar, Francisco
AU - Gottvall, Karin
AU - Berrut, Sylvie
AU - Macfarlane, Alison
N1 - Publisher Copyright:
© 2016 Royal College of Obstetricians and Gynaecologists
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons. Design: Population-based study. Setting: Twenty-seven European countries, the United States, Canada and Japan in 2010. Population: A total of 9 376 252 singleton births. Method: We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22–23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings. Main outcome measures: Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source. Results: Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22–23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22–23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged. Conclusions: International comparisons of very preterm birth rates using routine data should exclude births at 22–23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries. Tweetable abstract: International comparisons of VPT rates should exclude births at 22–23 weeks of gestation and terminations of pregnancy.
AB - Objective: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons. Design: Population-based study. Setting: Twenty-seven European countries, the United States, Canada and Japan in 2010. Population: A total of 9 376 252 singleton births. Method: We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22–23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings. Main outcome measures: Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source. Results: Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22–23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22–23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged. Conclusions: International comparisons of very preterm birth rates using routine data should exclude births at 22–23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries. Tweetable abstract: International comparisons of VPT rates should exclude births at 22–23 weeks of gestation and terminations of pregnancy.
KW - Euro-Peristat
KW - international comparisons
KW - preterm birth
KW - stillbirths
KW - very preterm
UR - http://www.scopus.com/inward/record.url?scp=84987936677&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84987936677&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.14273
DO - 10.1111/1471-0528.14273
M3 - Article
C2 - 27613083
AN - SCOPUS:84987936677
SN - 1470-0328
VL - 124
SP - 785
EP - 794
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 5
ER -