Variation in rates of postterm birth in Europe: reality or artefact?

Abstract

Objective To compare rates of postterm birth in Europe.Design Analysis of data from vital statistics, birth registers, and national birth samples collected for the PERISTAT project.Setting Thirteen European countries.Population All live births or representative samples of births for the year 2000 or most recent year available.Methods Comparison of national and regional rates of postterm birth. Other indicators (birthweight, deliveries with a non-spontaneous onset and mortality) were used to assess the validity of postterm rates.Main outcome measures The proportion of births at 42 completed weeks of gestation or later.Results Postterm rates varied greatly, from 0.4% (Austria, Belgium) to over 7% (Denmark, Sweden) of births. Higher postterm rates were associated with a greater proportion of babies with birthweight 4500 g or more. Fetal and early neonatal mortality rates were higher among postterm births than among births at 40 weeks. Countries with higher proportions of births with a nonspontaneous onset of labour had lower postterm birth rates. The shapes of the gestational-age distributions at term varied. In some countries, there was a sharp cutoff in deliveries at 40 weeks, while elsewhere this occurred at 41 weeks.Conclusions These results suggest that practices for managing pregnancies continuing beyond term differ in Europe and raise questions about the health and other impacts in countries with markedly high or low postterm rates. Some variability in these rates may also be due to methods for determining gestational age, which has broader implications for international comparisons of gestational age, including rates of postterm and preterm births and small-for-gestational-age newborns.

Maternal and fetal outcome in post term pregnancy

“…5,6 The incidence of post term pregnancy in present study is lower than the study conducted by Ingemarsson et al, Ahanya et al and by Marahatta R et al in Nepal, who reported the incidence of postdated pregnancy 8.3%, 7.6% and 4.6% respectively. [7][8][9] This lower incidence of post term pregnancy in our study may be because we do induction of labour at 40+ weeks in our centre.…”

Asphyxia, Neurologic Morbidity, and Perinatal Mortality in Early-Term and Postterm Birth

“…8 Despite an increasing overall number of delivery inductions, 12 the rate of early-term birth did not vary substantially, and the rate of postterm birth increased during the 20-year study period. Nevertheless, the incidences of perinatal mortality and long-term morbidity in our study population were comparable with those in 5 …”

“…The proportion of postterm birth seems to be decreasing. 8 Elevated risk for perinatal mortality and morbidity is associated with postterm birth. [9][10][11] In Finland, the rate of early-term birth is 17% to 18% and the rate of postterm birth is 4% to 5%.…”

Perinatal health monitoring in Europe: results from the EURO-PERISTAT project

“…At a European level, there are good arguments for collaboration in audits of perinatal and maternal deaths and of rare events or outcomes [25][26].…”