Influence of definition based versus pragmatic birth registration on international comparisons of perinatal and infant mortality: population based retrospective study

Joseph, K.S.; Liu, S.; Rouleau, Jocelyn; Lisonkova, Sarka; Hutcheon, Jennifer A.; Sauvé, Reg; Allen, Alexander C.; Kramer, Michael S.

doi:10.1136/bmj.e746

Cited by 111 publications

(117 citation statements)

References 12 publications

(9 reference statements)

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“…When overall stillbirth rates (including early and late gestation stillbirths) were compared between 28 HICs, Sweden ranked third best and Australia last (28th), but Sweden dropped to tenth and Australia improved to 11th when rank was based on stillbirths who weighed 1000 g or more. 15 Under-reporting of stillbirths less than 28 weeks is also evident in some regions. 3 Ascertainment of data might be affected by perceptions of viability.…”

Section: Early Gestation Stillbirthmentioning

confidence: 99%

Stillbirths: recall to action in high-income countries

et al. 2016

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Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.

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Section: Early Gestation Stillbirthmentioning

confidence: 99%

Stillbirths: recall to action in high-income countries

et al. 2016

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“…Several well-known institutions, such as the OECD, provide international rankings based on perinatal, infant and maternal mortality; however, the validity of these rankings is questionable because of wide variations in live birth and stillbirth registration practices [21][22][23][24][25]. Therefore, care must be taken when comparing perinatal health data between countries, since they use varying criteria to describe the same mortalities.…”

Section: Data Comparison Between Oecd Countriesmentioning

confidence: 99%

“…For industrialized countries, these differences are, at least in part, the result of vast differences in birth and death registration of infants near the borderline of viability; those with a birth weight of less than 500 g. Other potential sources of variation are the use of different cut-offs of gestational age and/ or birth weight for reporting fetal deaths and live births, as well as the classification of deaths as neonatal vs. stillbirths [16,23,25]. For this reason, the WHO recommends the use of a cutoff of at least 1,000 g for live births when making international comparisons of infant mortality [5].…”

Section: Data Comparison Between Oecd Countriesmentioning

confidence: 99%

Canada’s pregnancy-related mortality rates: doing well but room for improvement

Verstraeten¹,

Mijovic-Kondejewski²,

Takeda³

et al. 2015

CIM

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Canada's pregnancy-related mortality rates: doing well but room for improvement Abstract Purpose: Canada's perinatal, infant and maternal mortality rates were examined and compared with other Organization for Economic Cooperation and Development (OECD) countries. The type and the quality of the available data and best practices in several OECD countries were evaluated.Source: A literature search was performed in PubMed and the Cochrane Library. Vital statistics data were obtained from the OECD Health Database and Statistics Canada and subjected to secondary analysis.Principal findings: Overall, Canadian pregnancy mortality rates have fallen dramatically since the early 1960's. Perinatal and infant mortality rates remain low and stable, but the maternal mortality rate has increased slightly and both mortality rates have declined in their relative OECD rankings over the last 20 years. Data quality and coverage across Canada and internationally, especially for Indigenous peoples, is inconsistent and registration practices differ greatly, making comparisons difficult. Available data do show that Indigenous people's perinatal and infant mortality rates are nearly twice those of the general population. Best practices in other OECD countries include Australia's National Maternity Services plan to improve Aboriginal perinatal health, the Netherlands' midwifery services and National Perinatal Registry and Japan's national pregnancy registration and Maternal Handbook. Conclusion:To diminish Canadian disparities in perinatal health rates and improve health outcomes we recommend a) uniform registration practices across Canada, b) better data quality and coverage especially among Indigenous communities, c) adoption of a national pregnancy registration and a maternal handbook along with d) improved midwifery and primary practice services to rural and remote communities. At a time when Canada is focusing upon improving pregnancy health in developing nations, it also needs to address its own challenges in improving pregnancy outcomes.

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“…There is substantial international variability in stillbirth registration criteria 7, 8. For instance, Norway registers stillbirths ≥12 weeks of gestation, the Netherlands and the UK register stillbirths ≥24 weeks of gestation, whereas Italy requires registration at ≥180 days of gestation 1.…”

mentioning

confidence: 99%

“…Varying criteria for registration and variability in adherence with these criteria seriously limits the value of international comparisons of stillbirth rates. A study ranking 28 high‐income countries based on crude stillbirth rates resulted in Sweden receiving a rank of third, whereas the United States (ranked 23rd), Canada (27th), and Australia (28th) performed less well 7. However, ranks recalculated after restricting stillbirths to those ≥1000 g birthweight (i.e.…”

mentioning

confidence: 99%