Birth population survey in Huai’an in 2015: perinatal-neonatal mortality and preterm birth rate in emerging regions in China

Preterm Morbidity and Mortality by Gestational Age. A Birth Population-Based Study

“…By comparison, the 50% survival rate was reported in 23-25 weeks of gestation from the nation-wide registry or perinatal network data in developed countries [1][2][3][4][5][7][8][9]. Our previous data demonstrated substantial and persistent improvement in Huai'an perinatalneonatal care between 2010 and 2015, probably due to the establishment of centralized prenatal care and deliveries at level II and III hospitals [10,11,20]. This enabled us to take facility-speci c conditions and regional infrastructure into consideration, when investigating the impact of integrated antenatal, peripartum and postnatal interventions in this region.…”

“…The concept and protocol of investigation, de nition of diagnosis of preterm morbidity and mortality as well as speci c disease severity and level of care were adopted from the references cited in the manuscript, during the data collection, analysis and preparation of manuscript in 2018-2020. This study followed the whole regional birth population survey in 2015, in which a complete birth data was prospectively collected from totally 107 level I-III hospitals providing obstetric care (6 municipal, 16 county and 85 township), and 8 level II and 4 level III hospitals equipped with neonatal wards and/or intensive care units (NICU) [11,20]. Non-medical abortions (especially unplanned pregnancy) were excluded.…”

“…1). The study protocol was approved by the ethic committee of Children's Hospital of Fudan University, and accepted by HWCH as well as all participating hospitals in Huai'an [11,20]. As no speci c intervention was applied, informed consent from parents/guardians was waived.…”

“…Despite the majority of neonatal deaths attributed to preterm birth complication, and a large amount of hospital admission-based data by gestational age (GA) available in China, the whole picture of perinatal-neonatal care remains unclear due to a lack of birth population-based clinical surveys [6][7][8][9]. Although the number of Chinese annual birth population has reached 15-17 million in the past decade, with an established universal health insurance covering maternal-infant healthcare [10][11][12][13], there is a paucity of data on vital statistics of preterm births and assessment of combined effects of antenatal, peripartum and postnatal interventions on perinatal and neonatal outcome in the preterm birth and hospitalized population.…”

“…Huai'an is an emerging prefectural region in east China with 5.6-million population with 50% rural residents, the regional gross domestic production per capita approaching the national average level. According to our previous surveys of complete birth registries in Huai'an in 2015, a survival rate of more than 50% was observed in preterm infants with 27-28 gestational weeks and beyond [11]. By comparison, the 50% survival rate was reported in 23-25 weeks of gestation from the nation-wide registry or perinatal network data in developed countries [1][2][3][4][5][7][8][9].…”