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1. Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic:a study of 21 European countries

Author

Zeitlin, Jennifer, Philibert, Marianne, Barros, Henrique, Broeders, Lisa, Cap, Jan, Draušnik, Željka, Engjom, Hilde, Farr, Alex, Fresson, Jeanne, Gatt, Miriam, Gissler, Mika, Heller, Günther, Isakova, Jelena, Källén, Karin, Kyprianou, Theopisti, Loghi, Marzia, Monteath, Kirsten, Mortensen, Laust, Rihs, Tonia, Sakkeus, Luule, Sikora, Izabela, Szamotulska, Katarzyna, Velebil, Petr, Verdenik, Ivan, Weber, Guy, Zile, Irisa, Zurriaga, Oscar, Smith, Lucy, Zeitlin, Jennifer, Philibert, Marianne, Barros, Henrique, Broeders, Lisa, Cap, Jan, Draušnik, Željka, Engjom, Hilde, Farr, Alex, Fresson, Jeanne, Gatt, Miriam, Gissler, Mika, Heller, Günther, Isakova, Jelena, Källén, Karin, Kyprianou, Theopisti, Loghi, Marzia, Monteath, Kirsten, Mortensen, Laust, Rihs, Tonia, Sakkeus, Luule, Sikora, Izabela, Szamotulska, Katarzyna, Velebil, Petr, Verdenik, Ivan, Weber, Guy, Zile, Irisa, Zurriaga, Oscar, and Smith, Lucy

Abstract

Background Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries. Methods The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015–2020. SES was based on mother’s educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis. Results Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94–0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99–1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits. Conclusions PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups., BACKGROUND: Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries.METHODS: The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015-2020. SES was based on mother's educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis.RESULTS: Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94-0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99-1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits.CONCLUSIONS: PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups.

Published
2024

2. Neonatal Mortality Disparities by Gestational Age in European Countries

Author

Sartorius, Victor, Philibert, Marianne, Klungsoyr, Kari, Klimont, Jeannette, Szamotulska, Katarzyna, Drausnik, Zeljka, Velebil, Petr, Mortensen, Laust, Gissler, Mika, Fresson, Jeanne, Nijhuis, Jan, Zhang, Wei Hong, Källén, Karin, Rihs, Tonia A., Tica, Vlad, Matthews, Ruth, Smith, Lucy, Zeitlin, Jennifer, Sartorius, Victor, Philibert, Marianne, Klungsoyr, Kari, Klimont, Jeannette, Szamotulska, Katarzyna, Drausnik, Zeljka, Velebil, Petr, Mortensen, Laust, Gissler, Mika, Fresson, Jeanne, Nijhuis, Jan, Zhang, Wei Hong, Källén, Karin, Rihs, Tonia A., Tica, Vlad, Matthews, Ruth, Smith, Lucy, and Zeitlin, Jennifer

Abstract

Importance There are wide disparities in neonatal mortality rates (NMRs, deaths <28 days of life after live birth per 1000 live births) between countries in Europe, indicating potential for improvement. Comparing country-specific patterns of births and deaths with countries with low mortality rates can facilitate the development of effective intervention strategies. Objective To investigate how these disparities are associated with the distribution of gestational age (GA) and GA-specific mortality rates. Design, Setting, and Participants This was a cross-sectional study of all live births in 14 participating European countries using routine data compiled by the Euro-Peristat Network. Live births with a GA of 22 weeks or higher from 2015 to 2020 were included. Data were analyzed from May to October 2023. Exposures GA at birth. Main Outcomes and Measures The study investigated excess neonatal mortality, defined as a rate difference relative to the pooled rate in the 3 countries with the lowest NMRs (Norway, Sweden, and Finland; hereafter termed the top 3). The Kitagawa method was used to divide this excess into the proportion explained by the GA distribution of births and by GA-specific mortality rates. A sensitivity analysis was conducted among births 24 weeks’ GA or greater. Results There were 35 094 neonatal deaths among 15 123 428 live births for an overall NMR of 2.32 per 1000. The pooled NMR in the top 3 was 1.44 per 1000 (1937 of 1 342 528). Excess neonatal mortality compared with the top 3 ranged from 0.17 per 1000 in the Czech Republic to 1.82 per 1000 in Romania. Excess deaths were predominantly concentrated among births less than 28 weeks’ GA (57.6% overall). Full-term births represented 22.7% of the excess deaths in Belgium, 17.8% in France, 40.6% in Romania and 17.3% in the United Kingdom. Heterogeneous patterns were observed when partitioning excess mortality into the proportion associated with the GA distr, Importance: There are wide disparities in neonatal mortality rates (NMRs, deaths <28 days of life after live birth per 1000 live births) between countries in Europe, indicating potential for improvement. Comparing country-specific patterns of births and deaths with countries with low mortality rates can facilitate the development of effective intervention strategies. Objective: To investigate how these disparities are associated with the distribution of gestational age (GA) and GA-specific mortality rates. Design, Setting, and Participants: This was a cross-sectional study of all live births in 14 participating European countries using routine data compiled by the Euro-Peristat Network. Live births with a GA of 22 weeks or higher from 2015 to 2020 were included. Data were analyzed from May to October 2023. Exposures: GA at birth. Main Outcomes and Measures: The study investigated excess neonatal mortality, defined as a rate difference relative to the pooled rate in the 3 countries with the lowest NMRs (Norway, Sweden, and Finland; hereafter termed the top 3). The Kitagawa method was used to divide this excess into the proportion explained by the GA distribution of births and by GA-specific mortality rates. A sensitivity analysis was conducted among births 24 weeks' GA or greater. Results: There were 35 094 neonatal deaths among 15 123 428 live births for an overall NMR of 2.32 per 1000. The pooled NMR in the top 3 was 1.44 per 1000 (1937 of 1 342 528). Excess neonatal mortality compared with the top 3 ranged from 0.17 per 1000 in the Czech Republic to 1.82 per 1000 in Romania. Excess deaths were predominantly concentrated among births less than 28 weeks' GA (57.6% overall). Full-term births represented 22.7% of the excess deaths in Belgium, 17.8% in France, 40.6% in Romania and 17.3% in the United Kingdom. Heterogeneous patterns were observed when partitioning excess mortality into the proportion associated with the GA distribution vs GA-specific mortality. Fo

Published
2024

3. Trends in caesarean section rates in Europe from 2015 to 2019 using Robson's Ten Group Classification System: A Euro‐Peristat study

Author

Amyx, Melissa, Philibert, Marianne, Farr, Alex, Donati, Serena, Smárason, Alexander Kr, Tica, Vlad, Velebil, Petr, Alexander, Sophie, Durox, Mélanie, Elorriaga, Maria Fernandez, Heller, Günther, Kyprianou, Theopisti, Mierzejewska, Ewa, Verdenik, Ivan, Zīle‐Velika, Irisa, Zeitlin, Jennifer, Amyx, Melissa, Philibert, Marianne, Farr, Alex, Donati, Serena, Smárason, Alexander Kr, Tica, Vlad, Velebil, Petr, Alexander, Sophie, Durox, Mélanie, Elorriaga, Maria Fernandez, Heller, Günther, Kyprianou, Theopisti, Mierzejewska, Ewa, Verdenik, Ivan, Zīle‐Velika, Irisa, and Zeitlin, Jennifer

Abstract

Objective To assess changes in caesarean section (CS) rates in Europe from 2015 to 2019 and utilise the Robson Ten Group Classification System (TGCS) to evaluate the contribution of different obstetric populations to overall CS rates and trends. Design Observational study utilising routine birth registry data. Setting A total of 28 European countries. Population Births at ≥22 weeks of gestation in 2015 and 2019. Methods Using a federated model, individual‐level data from routine sources in each country were formatted to a common data model and transformed into anonymised, aggregated data. Main Outcome Measures By country: overall CS rate. For TGCS groups (by country): CS rate, relative size, relative and absolute contribution to overall CS rate. Results Among the 28 European countries, both the CS rates (2015, 16.0%–55.9%; 2019, 16.0%–52.2%) and the trends varied (from −3.7% to +4.7%, with decreased rates in nine countries, maintained rates in seven countries (≤ ± 0.2) and with increasing rates in 12 countries). Using the TGCS (for 17 countries), in most countries labour induction increased (groups 2a and 4a), whereas multiple pregnancies (group 8) decreased. In countries with decreasing overall CS rates, CS tended to decrease across all TGCS groups, whereas in countries with increasing rates, CS tended to increase in most groups. In countries with the greatest increase in CS rates (>1%), the absolute contributions of groups 1 (nulliparous term cephalic singletons, spontaneous labour), 2a and 4a (induction of labour), 2b and 4b (prelabour CS) and 10 (preterm cephalic singletons) to the overall CS rate tended to increase. Conclusions The TGCS shows varying CS trends and rates among countries of Europe. Comparisons between European countries, particularly those with differing trends, could provide insight into strategies to reduce CS without clinical indication., info:eu-repo/semantics/published

Published
2024

4. Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic: a study of 21 European countries.

Author

Zeitlin, Jennifer, Philibert, Marianne, Barros, Henrique, Broeders, Lisa, Cap, Jan, Draušnik, Željka, Engjom, Hilde, Farr, Alex, Fresson, Jeanne, Gatt, Miriam, Gissler, Mika, Heller, Günther, Isakova, Jelena, Källén, Karin, Kyprianou, Theopisti, Loghi, Marzia, Monteath, Kirsten, Mortensen, Laust, Rihs, Tonia, and Sakkeus, Luule

Subjects
*RESEARCH funding, *PREMATURE infants, *PERINATAL death, *META-analysis, *DESCRIPTIVE statistics, *RELATIVE medical risk, *PSYCHOLOGY of mothers, *QUALITY of life, *PARTICIPATION, *HEALTH equity, *CONFIDENCE intervals, *COVID-19 pandemic, *SOCIAL classes, *EDUCATIONAL attainment
Abstract

Background Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries. Methods The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015–2020. SES was based on mother's educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis. Results Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94–0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99–1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits. Conclusions PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Developing and testing a protocol using a common data model for federated collection and analysis of national perinatal health indicators in Europe

Author

Zeitlin, Jennifer, Philibert, Marianne, Estupiñán-Romero, Francisco, Loghi, Marzia, Sakkeus, Luule, Draušnik, Željka, Alcaide, Adela Recio, Durox, Mélanie, Cap, Jan, Dimnjakovic, Jelena, Misins, Janis, Bernal Delgado, Enrique, Thissen, Martin, and Gissler, Mika

Subjects
maternal, newborn, caesarean delivery, Articles, Birth data, Method Article, national statistics, federated analysis, perinatal, population health indicators
Abstract

Context: International comparisons of the health of mothers and babies provide essential benchmarks for guiding health practice and policy, but statistics are not routinely compiled in a comparable way. These data are especially critical during health emergencies, such as the coronavirus disease (COVID-19) pandemic. The Population Health Information Research Infrastructure (PHIRI) project aimed to promote the exchange of population data in Europe and included a Use Case on perinatal health. Objective: To develop and test a protocol for federated analysis of population birth data in Europe. Methods: The Euro-Peristat network with participants from 31 countries developed a Common Data Model (CDM) and R scripts to exchange and analyse aggregated data on perinatal indicators. Building on recommended Euro-Peristat indicators, complemented by a three-round consensus process, the network specified variables for a CDM and common outputs. The protocol was tested using routine birth data for 2015 to 2020; a survey was conducted assessing data provider experiences and opinions. Results: The CDM included 17 core data items for the testing phase and 18 for a future expanded phase. 28 countries and the four UK nations created individual person-level databases and ran R scripts to produce anonymous aggregate tables. Seven had all core items, 17 had 13-16, while eight had ≤12. Limitations were not having all items in the same database, required for this protocol. Infant death and mode of birth were most frequently missing. Countries took from under a day to several weeks to set up the CDM, after which the protocol was easy and quick to use. Conclusion: This open-source protocol enables rapid production and analysis of perinatal indicators and constitutes a roadmap for a sustainable European information system. It also provides minimum standards for improving national data systems and can be used in other countries to facilitate comparison of perinatal indicators.

Published
2023
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6. Population birth data and pandemic readiness in Europe

Author

Haidinger, Gerald Klimont, Jeannette Alexander, Sophie and Zhang, Wei-Hong Vandervelpen, Ele Delnord, Marie Kolarova, Rumyana Yordanova, Evelin Rodin, Urelija Drausnik, Zeljka and Filipovic-Grcic, Boris Kyprianou, Theopisti Scoutellas, Vasos Velebil, Petr Mortensen, Laust Hvas Sakkeus, Luule and Abuladze, Liili Gissler, Mika Blondel, Beatrice and Deneux-Tharaux, Catherine Durox, Melanie Philibert, Marianne and Zeitlin, Jennifer Fresson, Jeanne Heller, Guenther and Misselwitz, Bjoern Antsaklis, Aris Berbik, Istvan and Olafsdottir, Helga Sol Kearns, Karen Sikora, Izabela and Cuttini, Marina Loghi, Marzia Donati, Serena Boldrini, Rosalia Misins, Janis Zile, Irisa Isakova, Jelena and Touvrey-Lecomte, Aline Billy, Audrey Couffignal, Sophie and Weber, Guy Gatt, Miriam Nijhuis, Jan Broeders, Lisa and Achterberg, P. W. Hindori-Mohangoo, Ashna Klungsoyr, Kari and Akerkar, Rupali Engjom, Hilde Szamotulska, Katarzyna and Mierzejewska, Ewa Barros, Henrique Rodrigues, Carina Horga, Mihai Tica, Vlad Puscasiu, Lucian Budianu, Mihaela-Alexandra and Cucu, Alexandra Calomfirescu, Cristian Cap, Jan Mandic, Natasa Tul Verdenik, Ivan Zurriaga, Oscar Alcaide, Adela Recio Jane, Mireia Vidal, Maria Jose Kallen, Karin and Nyman, Anastasia Rihs, Tonia Macfarlane, Alison Wood, Rachael Monteath, Kirsten Smith, Lucy Morgan, Siobhan and Hillen, Jennifer Euro-Peristat Res Network and Haidinger, Gerald Klimont, Jeannette Alexander, Sophie and Zhang, Wei-Hong Vandervelpen, Ele Delnord, Marie Kolarova, Rumyana Yordanova, Evelin Rodin, Urelija Drausnik, Zeljka and Filipovic-Grcic, Boris Kyprianou, Theopisti Scoutellas, Vasos Velebil, Petr Mortensen, Laust Hvas Sakkeus, Luule and Abuladze, Liili Gissler, Mika Blondel, Beatrice and Deneux-Tharaux, Catherine Durox, Melanie Philibert, Marianne and Zeitlin, Jennifer Fresson, Jeanne Heller, Guenther and Misselwitz, Bjoern Antsaklis, Aris Berbik, Istvan and Olafsdottir, Helga Sol Kearns, Karen Sikora, Izabela and Cuttini, Marina Loghi, Marzia Donati, Serena Boldrini, Rosalia Misins, Janis Zile, Irisa Isakova, Jelena and Touvrey-Lecomte, Aline Billy, Audrey Couffignal, Sophie and Weber, Guy Gatt, Miriam Nijhuis, Jan Broeders, Lisa and Achterberg, P. W. Hindori-Mohangoo, Ashna Klungsoyr, Kari and Akerkar, Rupali Engjom, Hilde Szamotulska, Katarzyna and Mierzejewska, Ewa Barros, Henrique Rodrigues, Carina Horga, Mihai Tica, Vlad Puscasiu, Lucian Budianu, Mihaela-Alexandra and Cucu, Alexandra Calomfirescu, Cristian Cap, Jan Mandic, Natasa Tul Verdenik, Ivan Zurriaga, Oscar Alcaide, Adela Recio Jane, Mireia Vidal, Maria Jose Kallen, Karin and Nyman, Anastasia Rihs, Tonia Macfarlane, Alison Wood, Rachael Monteath, Kirsten Smith, Lucy Morgan, Siobhan and Hillen, Jennifer Euro-Peristat Res Network

Published
2022

7. Population birth data and pandemic readiness in Europe

Author

Haidinger, Gerald, Klimont, Jeannette, Alexander, Sophie, Zhang, Wei-Hong, Vandervelpen, Ele, Delnord, Marie, Kolarova, Rumyana, Yordanova, Evelin, Rodin, Urelija, Drausnik, Zeljka, Filipovic-Grcic, Boris, Kyprianou, Theopisti, Scoutellas, Vasos, Velebil, Petr, Mortensen, Laust Hvas, Sakkeus, Luule, Abuladze, Liili, Gissler, Mika, Blondel, Beatrice, Deneux-Tharaux, Catherine, Durox, Melanie, Philibert, Marianne, Zeitlin, Jennifer, Fresson, Jeanne, Heller, Guenther, Misselwitz, Bjoern, Antsaklis, Aris, Berbik, Istvan, Olafsdottir, Helga Sol, Kearns, Karen, Sikora, Izabela, Cuttini, Marina, Loghi, Marzia, Donati, Serena, Boldrini, Rosalia, Misins, Janis, Zile, Irisa, Isakova, Jelena, Touvrey-Lecomte, Aline, Billy, Audrey, Couffignal, Sophie, Weber, Guy, Gatt, Miriam, Nijhuis, Jan, Broeders, Lisa, Achterberg, P. W., Hindori-Mohangoo, Ashna, Klungsoyr, Kari, Akerkar, Rupali, Engjom, Hilde, Szamotulska, Katarzyna, Mierzejewska, Ewa, Barros, Henrique, Rodrigues, Carina, Horga, Mihai, Tica, Vlad, Puscasiu, Lucian, Budianu, Mihaela-Alexandra, Cucu, Alexandra, Calomfirescu, Cristian, Cap, Jan, Mandic, Natasa Tul, Verdenik, Ivan, Zurriaga, Oscar, Alcaide, Adela Recio, Jane, Mireia, Vidal, Maria Jose, Kallen, Karin, Nyman, Anastasia, Rihs, Tonia, Macfarlane, Alison, Wood, Rachael, Monteath, Kirsten, Smith, Lucy, Morgan, Siobhan, Hillen, Jennifer, Haidinger, Gerald, Klimont, Jeannette, Alexander, Sophie, Zhang, Wei-Hong, Vandervelpen, Ele, Delnord, Marie, Kolarova, Rumyana, Yordanova, Evelin, Rodin, Urelija, Drausnik, Zeljka, Filipovic-Grcic, Boris, Kyprianou, Theopisti, Scoutellas, Vasos, Velebil, Petr, Mortensen, Laust Hvas, Sakkeus, Luule, Abuladze, Liili, Gissler, Mika, Blondel, Beatrice, Deneux-Tharaux, Catherine, Durox, Melanie, Philibert, Marianne, Zeitlin, Jennifer, Fresson, Jeanne, Heller, Guenther, Misselwitz, Bjoern, Antsaklis, Aris, Berbik, Istvan, Olafsdottir, Helga Sol, Kearns, Karen, Sikora, Izabela, Cuttini, Marina, Loghi, Marzia, Donati, Serena, Boldrini, Rosalia, Misins, Janis, Zile, Irisa, Isakova, Jelena, Touvrey-Lecomte, Aline, Billy, Audrey, Couffignal, Sophie, Weber, Guy, Gatt, Miriam, Nijhuis, Jan, Broeders, Lisa, Achterberg, P. W., Hindori-Mohangoo, Ashna, Klungsoyr, Kari, Akerkar, Rupali, Engjom, Hilde, Szamotulska, Katarzyna, Mierzejewska, Ewa, Barros, Henrique, Rodrigues, Carina, Horga, Mihai, Tica, Vlad, Puscasiu, Lucian, Budianu, Mihaela-Alexandra, Cucu, Alexandra, Calomfirescu, Cristian, Cap, Jan, Mandic, Natasa Tul, Verdenik, Ivan, Zurriaga, Oscar, Alcaide, Adela Recio, Jane, Mireia, Vidal, Maria Jose, Kallen, Karin, Nyman, Anastasia, Rihs, Tonia, Macfarlane, Alison, Wood, Rachael, Monteath, Kirsten, Smith, Lucy, Morgan, Siobhan, and Hillen, Jennifer

Published
2022

8. Epidémiologie de la mortalité maternelle en France, de 1996 à 2002 : fréquence, facteurs et causes

Author

Philibert, Marianne, Boisbras, Fabien, Bouvier-Colle, Marie-Hélène, Recherches épidémiologiques en santé périnatale et santé des femmes, and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
enquête confidentielle, mortalité maternelle, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, soins non optimaux, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, morts « évitables »
Abstract

National audience; La mortalité maternelle est un indicateur de la qualité des soins obstétricaux. La France a mis en place en 1996 un système de surveillance comportant le suivi des taux et des causes et une enquête confidentielle conduisant à leur expertise. Les définitions utilisées sont celles de l'Organisation Mondiale de la Santé. Une première analyse porte sur les données observées à partir des statistiques de l'état civil, en particulier les taux (rapport des décès obstétricaux aux naissances vivantes); la seconde analyse repose sur l'Enquête confidentielle des décès maternels et leur expertise par le Comité national d'experts (pourcentage d'évitabilité). Le taux est estimé entre 9 à 13 décès pour 100 000 naissances vivantes. Après une diminution enregistrée entre 1996 et 2000, l'évolution plus récente est moins favorable. Le taux augmente avec l'âge (risque 8 fois plus élevé à 40 ans qu'à 20-24 ans) et selon la nationalité (taux deux fois plus élevé parmi les femmes non Européennes). La France se situe dans une position moyenne parmi les pays comparables et pourrait mieux faire, à l'image de la Finlande (6 pour 100 000). Quatre-vingt-quatre pour cent des décès ont lieu dans un hôpital public, 10% dans une clinique privée et 6% à domicile. La première cause est due aux hémorragies (21% des décès maternels) principalement du post partum, suivies des complications de l'hypertension (HTA, 12%) puis des embolies amniotiques (7%). La moitié des décès maternels de causes obstétricales directes sont considérés « évitables » (73% des hémorragies, 71% des infections mais seulement 43% des HTA). De nombreuses améliorations sont encore possibles, pour connaître les raisons conduisant à ce drame, et pour y remédier ainsi qu'aux soins non optimaux, puisque des pays Européens comparables au nôtre continuent de faire mieux.

Published
2006

9. Maternal mortality Epidemiology in France, 1996-2002 : frequency, factors and causes

Author

Philibert, Marianne, Boisbras, Fabien, Bouvier-Colle, Marie-Hélène, Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
enquête confidentielle, mortalité maternelle, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, soins non optimaux, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, morts « évitables »
Abstract

National audience; La mortalité maternelle est un indicateur de la qualité des soins obstétricaux. La France a mis en place en 1996 un système de surveillance comportant le suivi des taux et des causes et une enquête confidentielle conduisant à leur expertise. Les définitions utilisées sont celles de l'Organisation Mondiale de la Santé. Une première analyse porte sur les données observées à partir des statistiques de l'état civil, en particulier les taux (rapport des décès obstétricaux aux naissances vivantes); la seconde analyse repose sur l'Enquête confidentielle des décès maternels et leur expertise par le Comité national d'experts (pourcentage d'évitabilité). Le taux est estimé entre 9 à 13 décès pour 100 000 naissances vivantes. Après une diminution enregistrée entre 1996 et 2000, l'évolution plus récente est moins favorable. Le taux augmente avec l'âge (risque 8 fois plus élevé à 40 ans qu'à 20-24 ans) et selon la nationalité (taux deux fois plus élevé parmi les femmes non Européennes). La France se situe dans une position moyenne parmi les pays comparables et pourrait mieux faire, à l'image de la Finlande (6 pour 100 000). Quatre-vingt-quatre pour cent des décès ont lieu dans un hôpital public, 10% dans une clinique privée et 6% à domicile. La première cause est due aux hémorragies (21% des décès maternels) principalement du post partum, suivies des complications de l'hypertension (HTA, 12%) puis des embolies amniotiques (7%). La moitié des décès maternels de causes obstétricales directes sont considérés « évitables » (73% des hémorragies, 71% des infections mais seulement 43% des HTA). De nombreuses améliorations sont encore possibles, pour connaître les raisons conduisant à ce drame, et pour y remédier ainsi qu'aux soins non optimaux, puisque des pays Européens comparables au nôtre continuent de faire mieux.

Published
2006

10. Follow-up after very preterm birth in Europe

Author

Stavros Petrou, Sung Wook Kim, Henrique Barros, Liis Toome, Marina Cuttini, Arno van Heijst, Elizabeth S Draper, Jennifer Zeitlin, Anna-Veera Seppänen, Lazaros Andronis, Pernille Pedersen, Ulrika Ådén, Rolf F. Maier, Jo Lebeer, Janusz Gadzinowski, SHIPS Res Grp, PHILIBERT, Marianne, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Collège Doctoral, Sorbonne Université (SU), Department of Health Sciences [Leicester], University of Leicester, Warwick Medical School, University of Warwick [Coventry], Nuffield Department of Primary Care Health Sciences, University of Oxford, University of Oxford, Epidemiology Research Unit [Porto, Portugal] (EPIUnit), Instituto de Saúde Pública [Porto, Portugal], Universidade do Porto = University of Porto-Universidade do Porto = University of Porto, Children's Hospital [Marburg, Germany] (University Hospital), Philipps Universität Marburg = Philipps University of Marburg, Department of Neonatology [Hvidovre, Denmark], Hvidovre Hospital, Department of Neonatology [Poznań, Poland], Poznan University of Medical Sciences [Poznan, Poland], Department of Primary & Interdisciplinary Care, Disability Studies [Antwerpen, Belgium] (Faculty of Medicine), University of Antwerp (UA), Women's and Children's Health [Stockholm, Sweden], Karolinska Institutet [Stockholm], Tallinn Children's Hospital [Tallinn, Estonia], University of Tartu, Radboud University Medical Center [Nijmegen], Clinical Care and Management Innovation Research Area [Roma, Lazio, Italy], Children's Hospital Bambino Gesù IRCCS [Rome], SHIPS Research Group, Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Oxford [Oxford], Universidade do Porto-Universidade do Porto, and Philipps University Marburg [Germany]

Subjects
medicine.medical_specialty, Pediatrics, [SDV]Life Sciences [q-bio], Psychological intervention, Aftercare, Child Welfare, neonatology, 03 medical and health sciences, Child Development, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Intensive care, Epidemiology, Prevalence, medicine, Humans, Very Preterm Birth, 030212 general & internal medicine, Neonatology, ComputingMilieux_MISCELLANEOUS, business.industry, Infant, Newborn, Health services research, Infant, Obstetrics and Gynecology, Gestational age, General Medicine, PostScript, health services research, Patient Discharge, 3. Good health, Europe, [SDV] Life Sciences [q-bio], Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Cohort, Premature Birth, epidemiology, Human medicine, business, Follow-Up Studies
Abstract

Follow-up programmes aim to detect neurodevelopmental and health problems and enable early interventions for children born very preterm (

Published
2021
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11. Managing mother’s own milk for very preterm infants in neonatal units in 11 European countries

Author

Rolf F. Maier, Véronique Pierrat, Jennifer Zeitlin, Henrique Barros, Marina Cuttini, Emilija Wilson, Carina Rodrigues, Liis Toome, Epidemiology Research Unit [Porto, Portugal] (EPIUnit), Instituto de Saúde Pública [Porto, Portugal], Universidade do Porto-Universidade do Porto, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Dpt of Women's and Children's Health [Stockholm], Karolinska University Hospital [Stockholm], Tallinn Children's Hospital [Tallinn, Estonia], University of Tartu, Clinical Care and Management Innovation Research Area [Rome, Italy], Children's Hospital Bambino Gesù IRCCS [Rome], IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Children's Hospital [Marburg, Germany] (University Hospital), Philipps University Marburg [Germany], Departamento de Ciências da Saúde Pública e Forenses e Educação Médica [Porto, Portugal], Faculdade de Medicina da Universidade do Porto (FMUP), Foundation for Science and Technology - FCT (Portuguese Ministry of Science, Technology and Higher Education) Operational Programmes Competitiveness and Internationalization (COMPETE 2020) Human Capital (POCH), Portugal 2020, under the EPIUnit POCI-01-0145-FEDER-006862 UID/DTP/04750/2019SFRH/BD/111794/2015, EPICE Research Group, European Project: 259882,EC:FP7:HEALTH,FP7-HEALTH-2010-two-stage,EPICE(2011), Universidade do Porto = University of Porto-Universidade do Porto = University of Porto, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Philipps Universität Marburg = Philipps University of Marburg, PHILIBERT, Marianne, and Effective Perinatal Intensive Care in Europe: translating knowledge into evidence based practice - EPICE - - EC:FP7:HEALTH2011-01-01 - 2015-12-31 - 259882 - VALID

Subjects
Pediatrics, medicine.medical_specialty, [SDV]Life Sciences [q-bio], MEDLINE, Mothers, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive Care Units, Neonatal, medicine, Animals, Humans, Infant, Very Low Birth Weight, 030212 general & internal medicine, Infant Nutritional Physiological Phenomena, ComputingMilieux_MISCELLANEOUS, Milk, Human, business.industry, Infant, Newborn, Infant, General Medicine, [SDV] Life Sciences [q-bio], Very preterm, Europe, Breast Feeding, Pediatrics, Perinatology and Child Health, Female, business, Breast feeding, Infant, Premature
Abstract

International audience; no abstract available

Published
2021
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12. Counting stillbirths and COVID 19-there has never been a more urgent time

Author

Rakhi Dandona, Rafat Jan, Fleurisca J. Korteweg, Salome Maswime, Hannah Blencowe, Miranda Davies-Tuck, Claire Storey, Clare Whitehead, Peter Waiswa, Vicki Flenady, John Bolgna, Susannah Hopkins Leisher, Richard Chawana, Paula Quigley, Lisa M Vallely, Aliki Christou, Caroline S.E. Homer, Joseph Akuze, Sanne J. Gordijn, Delly Babona, Neelam Aggarwal, Jennifer Zeitlin, Adrienne Gordon, Margaret M. Murphy, Burnet Institute [Melbourne, Victoria], International Stillbirth Alliance [Millburn, NJ, USA] (ISA), Columbia University [New York], University of Queensland [Brisbane], Post Graduate Institute of Medical Education & Research [Chandigarh, India], London School of Hygiene and Tropical Medicine (LSHTM), Makerere University [Kampala, Ouganda] (MAK), St Mary's Hospital Vunapope [Kokopo, Papua New Guinea], Modillon Hospital [Madang, Papua New Guinea], University of the Witwatersrand [Johannesburg] (WITS), Biovac [Cape Town, South Africa], The University of Sydney, Hudson Institute of Medical Research [Clayton], Monash University [Clayton], Indian Institute of Public Health of Delhi, Washington State University (WSU), University of Groningen [Groningen], Royal Prince Alfred Hospital [Sydney, Australia], The Aga Khan University, University Medical Center Groningen [Groningen] (UMCG), University of Cape Town, University College Cork (UCC), Technical Assistance to Strengthen Capabilities Project [London, UK], DAI Global Health [London, UK], University of New South Wales [Sydney] (UNSW), Papua New Guinea Institute for Medical Research (PNGIMR), The Royal Melbourne Hospital, Mercy Hospital For Women [Heidelberg, VIC, Australia], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Southern Queensland (USQ), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and PHILIBERT, Marianne

Subjects
2019-20 coronavirus outbreak, Pediatrics, medicine.medical_specialty, Pregnancy risk, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), [SDV]Life Sciences [q-bio], MEDLINE, medicine.disease_cause, Global Health, 03 medical and health sciences, 0302 clinical medicine, Lockdown, Global health, Medicine, Humans, 030212 general & internal medicine, Neonatal care, ComputingMilieux_MISCELLANEOUS, Coronavirus, 030219 obstetrics & reproductive medicine, business.industry, lcsh:Public aspects of medicine, COVID-19, lcsh:RA1-1270, General Medicine, Stillbirth, Child mortality, [SDV] Life Sciences [q-bio], 0605 Microbiology, 1117 Public Health and Health Services, business, Stillbirths
Abstract

International audience; No abstract available

Published
2020
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13. Neighborhood Racial And Economic Polarization, Hospital Of Delivery, And Severe Maternal Morbidity

Author

Janevic, Teresa, Zeitlin, Jennifer, Egorova, Natalia, Hebert, Paul L., Balbierz, Amy, Howell, Elizabeth, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Washington [Seattle], Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and PHILIBERT, Marianne

Subjects
[SDV]Life Sciences [q-bio], Racial Groups, Quality of care, Health conditions, Diseases, Low income, Article, Hospitals, White People, Health policy, Severe maternal morbidity, [SDV] Life Sciences [q-bio], Black or African American, Pregnancy, Housing, Humans, Disparities in quality, Hospital quality, Female, New York City, Maternal health, Morbidity, Disparities in access, Health disparities, Mortality
Abstract

International audience; Recent national and state legislation has called attention to stark racial/ethnic disparities in maternal mortality and severe maternal morbidity (SMM), the latter of which is defined as having a life-threatening condition or life-saving procedure during childbirth. Using linked New York City birth and hospitalization data for 2012-14, we examined whether racial and economic spatial polarization is associated with SMM rates, and whether the delivery hospital partially explains the association. Women in ZIP codes with the highest concentration of poor blacks relative to wealthy whites experienced 4.0 cases of SMM per 100 deliveries, compared with 1.7 cases per 100 deliveries among women in the neighborhoods with the lowest concentration (risk difference = 2.4 cases per 100). Thirty-five percent of this difference was attributable to the delivery hospital. Women in highly polarized neighborhoods were most likely to deliver in hospitals located in similarly polarized neighborhoods. Housing policy that targets racial and economic spatial polarization may address a root cause of SMM, while hospital quality improvement may mitigate the impact of such polarization.

Published
2020
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14. Cohort profile : effective Perinatal Intensive Care in Europe (EPICE) very preterm birth cohort

Author

Zeitlin, J, Maier, RF, Cuttini, M, Aden, U, Boerch, K, Gadzinowski, J, Jarreau, P-H, Lebeer, J, Norman, M, Pedersen, P, Petrou, S, Pfeil, JM, Toome, L, van Heijst, A, van Reempts, P, Varendi, H, Barros, H, Groups, EPICE and SHIPS Research, Sarrechia, Iemke, EPICE Reseach Group, SHIPS Research Group, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), DHU Risques Et Grossesse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Philipps Universität Marburg = Philipps University of Marburg, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Department of Women's and Children's Health [Stockholm, Sweden], Karolinska University Hospital [Stockholm], Copenhagen University Hospital Hvidovre [Hvidovre, Danemark], University of Copenhagen = Københavns Universitet (UCPH), Poznan University of Medical Sciences [Poland] (PUMS), Department of Primary & Interdisciplinary Care, Disability Studies [Antwerpen, Belgium] (Faculty of Medicine), University of Antwerp (UA), Department of Clinical Science, Intervention and Technology [Stockholm, Sweden], Karolinska Institutet [Stockholm], Aalborg University [Denmark] (AAU), Warwick Medical School, University of Warwick [Coventry], Nuffield Department of Primary Care Health Sciences, University of Oxford, University of Oxford, European Foundation for the Care of Newborn Infants [Munich, Germany] (EFCNI), Tallinn Children's Hospital [Tallinn, Estonia], University of Tartu, Radboud University Medical Center [Nijmegen], Antwerp University Hospital [Edegem] (UZA), Study Centre for Perinatal Epidemiology [Brussels, Belgium] (SCPE), Tartu University Hospital [Tartu, Estonia], Instituto de Saúde Pública da Universidade do Porto [Porto, Portugal] (ISPUP), Universidade do Porto = University of Porto, University of Leicester, EPICE and SHIPS Research Group: J Lebeer, P Van Reempts, E Bruneel, E Cloet, A Oostra, E Ortibus, I Sarrechia, K Boerch, L Huusom, P Pedersen, T Weber, L Toome, H Varendi, M Männamaa, P Y Ancel, A Burguet, P H Jarreau, V Pierrat, P Truffert, R F Maier, M Zemlin, B Misselwitz, S Schmidt, L Wohlers, M Cuttini, D Di Lallo, G Ancora, D Baronciani, V Carnielli, I Croci, G Faldella, F Ferrari, F Franco, G Gargano, A van Heijst, C Koopman-Esseboom, J Gadzinowski, J Mazela, A Montgomery, T Pikuła, H Barros, R Costa, L Mendes Graça, M do Céu Machado, C Rodrigues, T Rodrigues, U Aden, A K Edstedt Bonamy, M Norman, E S Draper, E M Boyle, A Fenton, S J Johnson, B N Manktelow, D W A Milligan, S Mader, N Thiele, J M Walz, S Petrou, J Zeitlin, M Bonet, C Bonnet, R El Raffei, A Piedvache, A V Seppanen, PHILIBERT, Marianne, Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Philipps University of Marburg, University of Copenhagen = Københavns Universitet (KU), University of Oxford [Oxford], and Universidade do Porto

Subjects
Critical Care, [SDV]Life Sciences [q-bio], Infant, Newborn, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Cohort Studies, Europe, [SDV] Life Sciences [q-bio], Perinatal Care, Treatment Outcome, Pregnancy, Infant, Extremely Premature, Humans, Premature Birth, Female, Human medicine, Cohort Profiles, ComputingMilieux_MISCELLANEOUS
Abstract

Contains fulltext : 220753.pdf (Publisher’s version ) (Open Access)

Published
2020
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15. Race and Ethnicity, Medical Insurance, and Within-Hospital Severe Maternal Morbidity Disparities

Author

Paul L. Hebert, Natalia N. Egorova, Elizabeth A. Howell, Amy Balbierz, Teresa Janevic, Michael Brodman, Jennifer Zeitlin, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Department of Epidemiology [Seattle, WA, USA] (School of Public Health), University of Washington [Seattle], PHILIBERT, Marianne, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adult, Adolescent, Cross-sectional study, [SDV]Life Sciences [q-bio], Ethnic group, Birth certificate, Logistic regression, White People, Article, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Humans, Medicine, 030212 general & internal medicine, Young adult, health care economics and organizations, Insurance, Health, 030219 obstetrics & reproductive medicine, Medicaid, business.industry, Obstetrics and Gynecology, Hispanic or Latino, Odds ratio, Middle Aged, Delivery, Obstetric, medicine.disease, Hospitals, Patient Discharge, United States, 3. Good health, Black or African American, Pregnancy Complications, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Logistic Models, Female, New York City, Morbidity, business, Demography
Abstract

International audience; Objective: To examine within-hospital racial and ethnic disparities in severe maternal morbidity rates and determine whether they are associated with differences in types of medical insurance.Methods: We conducted a population-based, cross-sectional study using linked 2010-2014 New York City discharge and birth certificate data sets (N=591,455 deliveries) to examine within-hospital black-white, Latina-white, and Medicaid-commercially insured differences in severe maternal morbidity. We used logistic regression to produce risk-adjusted rates of severe maternal morbidity for patients with commercial and Medicaid insurance and for black, Latina, and white patients within each hospital. We compared these within-hospital adjusted rates using paired t-tests and conditional logit models.Results: Severe maternal morbidity was higher among black and Latina women than white women (4.2% and 2.9% vs 1.5%, respectively, P

Published
2020
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16. The Impact of Severe Maternal Morbidity on Very Preterm Infant Outcomes

Author

Natalia N. Egorova, Paul L. Hebert, Jennifer Zeitlin, Elodie Lebreton, Teresa Janevic, Amy Balbierz, Elizabeth A. Howell, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Icahn School of Medicine at Mount Sinai [New York] (MSSM), University of Washington [Seattle], Service de santé numérique [Paris] (SESAN), United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) R01HD078565United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Minority Health & Health Disparities (NIMHD) R01MD007651United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) R01HD078565, PHILIBERT, Marianne, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adult, medicine.medical_specialty, Very Preterm Infant, [SDV]Life Sciences [q-bio], Infant, Premature, Diseases, macromolecular substances, Severity of Illness Index, Article, maternal morbidity, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, 030225 pediatrics, Prevalence, medicine, Humans, 030212 general & internal medicine, Risk factor, Retrospective Studies, business.industry, Obstetrics, Infant, Newborn, Infant, Obstetrics and Gynecology, Gestational age, General Medicine, medicine.disease, Infant mortality, 3. Good health, infant mortality, Pregnancy Complications, [SDV] Life Sciences [q-bio], NICU admissions, Bronchopulmonary dysplasia, preterm birth, Case-Control Studies, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Small for gestational age, Female, New York City, business
Abstract

International audience; Objective: To estimate the prevalence of severe maternal morbidity among very preterm births and determine its association with very preterm infant mortality and morbidity.Study design: This study used New York City Vital Statistics birth and death records linked with maternal and newborn discharge abstract data for live births between 2010 and 2014. We included 6901 infants without congenital anomalies born between 240/7 and 326/7 weeks of gestation. Severe maternal morbidity was identified as life-threatening conditions or life-saving procedures. Outcomes were first-year infant mortality, severe neonatal morbidity (bronchopulmonary dysplasia, severe necrotizing enterocolitis, stage 3-5 retinopathy of prematurity, and intraventricular hemorrhage grades 3-4), and a combined outcome of death or morbidity.Results: Twelve percent of very preterm live-born infants had a mother with severe maternal morbidity. Maternal and pregnancy characteristics associated with occurrence of severe maternal morbidity were multiparity, being non-Hispanic black, and preexisting health conditions, but gestational age and the percentage small for gestational age did not differ. Infants whose mothers experienced severe maternal morbidity had higher first-year mortality, 11.2% vs 7.7% without severe maternal morbidity, yielding a relative risk of 1.39 (95% CI: 1.14-1.70) after adjustment for maternal characteristics, preexisting comorbidities, pregnancy complications, and hospital factors. Severe neonatal morbidity was not associated with severe maternal morbidity.Conclusions: Severe maternal morbidity is an independent risk factor for mortality in the first year of life among very preterm infants after consideration of other maternal and pregnancy risk factors.

Published
2019
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17. Producing valid statistics when legislation, culture, and medical practices differ for births at or before the threshold of survival: Report of a European workshop

Author

Smith, L. K., Blondel, B., Zeitlin, J., Haidinger, G., Alexander, S., Kolarova, R., Rodin, U., Kyprianou, T., Velebil, P., Mortensen, L., Sakkeus, L., Gissler, M., Heller, G., Lack, N., Antsaklis, A., Berbik, I., Olafsdottir, H., Bonham, S., Cuttini, M., Misins, J., Isakova, J., Wagener, Y., Gatt, M., Nijhuis, J., Klungsoyr, K., Szamotulska, K., Barros, H., Horga, M., Cap, J., Tul, N., Bolumar, F., Gottvall, K., Kallen, K., Berrut, S., Riggenbach, M., Macfarlane, A. J., Zeitlin, J, Delnord, M., Durox, M., Hindori-Mohangoo, A., RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: MA Obstetrie Gynaecologie (3), Obstetrie & Gynaecologie, Department of Health Sciences [Leicester], University of Leicester, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Euro-Peristat Scientific Committee: Gerald Haidinger, Sophie Alexander, Urelija Rodin, Theopisti Kyprianou, Petr Velebil, Laust Mortensen, Luule Sakkeus, Mika Gissler, Günther Heller, Nicholas Lack, Aris Antsaklis, István Berbik, Helga Sól Ólafsdóttir, Sheelagh Bonham, Marina Cuttini, Janis Misins, Jelena Isakova, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Natasa Tul, Francisco Bolúmar, Karin Gottvall, Karin Källén, Sylvan Berrut, Mélanie Riggenbach, Alison Macfarlane, Marie Delnord, Mélanie Durox, Ashna Hindori-Mohangoo, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and PHILIBERT, Marianne

Subjects
COUNTRIES, Quality management, Internationality, STILLBIRTHS, [SDV]Life Sciences [q-bio], Consensus Development Conferences as Topic, Perinatal Death, MEDLINE, Legislation, Gestational Age, Population health, DEFINITIONS, 03 medical and health sciences, 0302 clinical medicine, FETAL-DEATH, Environmental health, Medicine, Humans, RATES, ComputingMilieux_MISCELLANEOUS, Perinatal Mortality, Analysis of Variance, 030219 obstetrics & reproductive medicine, business.industry, Mortality rate, International comparisons, PRETERM BIRTHS, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Public Reporting of Healthcare Data, Stillbirth, Quality Improvement, 3. Good health, [SDV] Life Sciences [q-bio], Europe, Vital Statistics, Perinatal Care, Commentary, Gestation, RG, business
Abstract

Perinatal mortality is a major population health indicatorconveying important signals about the state of maternitycare and measures of the current and future health ofmothers and newborns. International comparisons are usedto encourage countries to improve their perinatal healthand health systems. However, extensive evidence highlightsmethodological challenges to ensuring valid and robustcomparisons, as a lack of standardised criteria can lead tobias and inappropriate inferences.One major issue is the wide international variation in the criteria for classification and registration of deaths as a stillbirth or neonatal death at the threshold of survival.Standard practice is to minimise this problem by using a gestational age cut-off of 24 or even 28 weeks for mortality rate calculations. However, this strategy excludes a significant number of stillbirths, at least one in five deaths before 24 weeks of gestation and over one in three deaths before 28 weeks.As the gestational age limit for initiation of neonatal care decreases, exclusion of these stillbirths limits the full evaluation ofcare provision and outcomes at early gestational ages. Fur-ther, it underestimates the burden of loss on parents’ men-tal and physical health.

Published
2019
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18. Perinatal health monitoring through a European lens: eight lessons from the Euro-Peristat report on 2015 births

Author

Sophie Alexander, Béatrice Blondel, Alice Hocquette, Ashna D Hindori-Mohangoo, Jennifer Zeitlin, Henrique Barros, Alison Macfarlane, Marie Delnord, Katarzyna Szamotulska, Mika Gissler, Mélanie Durox, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université libre de Bruxelles (ULB), Universidade do Porto, Sciensano [Bruxelles], Réseau International des Instituts Pasteur (RIIP), National Institute for Health and Welfare [Helsinki], Karolinska Institutet [Stockholm], The Netherlands Organisation for Applied Scientific Research (TNO), Foundation for the Advancement of Scientific Research in Suriname [Paramaribo] (SWOS), Tulane University, National Research Institute of Mother and Child [Warsaw, Poland], Centre for Maternal and Child Health Research [London, UK], City University London, European Health Programme through the Information for Action (InfAct) collaboration BRIDGE Health project Institut national de la sante et de la recherche medicale (INSERM) in Paris, Euro-Peristat Scientific Committee, PHILIBERT, Marianne, and Universidade do Porto = University of Porto

Subjects
Adult, Maternal welfare, Maternal-Child Health Services, Monitoring, RJ, [SDV]Life Sciences [q-bio], Population, Iceland, Maternal Welfare, MEDLINE, Audit, 03 medical and health sciences, Fetus, 0302 clinical medicine, Pregnancy, Environmental health, Health care, medicine, Humans, Healthcare Disparities, education, Perinatal Mortality, ComputingMilieux_MISCELLANEOUS, education.field_of_study, Mother, 030219 obstetrics & reproductive medicine, Norway, business.industry, Infant, Newborn, Infant, Obstetrics and Gynecology, Gestational age, medicine.disease, 3. Good health, Europe, [SDV] Life Sciences [q-bio], Population Surveillance, Female, Aggregate data, RG, business, Switzerland, Human
Abstract

In November 2018, the Euro-Peristat collaboration published a new European Perinatal Health Report based on national-level indicators of mothers’ and babies’ health in 2015 in current EU member states and Iceland, Norway, and Switzerland, a total of 31 countries with over five million births.1 Euro-Peristat’s indicator set includes ten core and 20 recommended indicators of fetal and newborn health, maternal health, characteristics of the childbearing population, and healthcare services.2 Indicators are compiled from population-based routine sources, such as civil registration systems, administrative or medical birth registers, audits, and surveys.3 A standardised protocol is used and integrates clinically relevant subgroups, notably gestational age and birthweight. Each country provides aggregate data for all births at ≥22 completed weeks of gestation, or ≥500 g birthweight if gestational age is missing. If this is not possible, other clearly specified national criteria are used. Euro-Peristat relies on the active involvement of national teams to compile, verify, and interpret the indicators.

Published
2019
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19. Quantifying the burden of stillbirths before 28 weeks of completed gestational age in high-income countries: a population-based study of 19 European countries

Author

Lucy K Smith, Ashna D Hindori-Mohangoo, Marie Delnord, Mélanie Durox, Katarzyna Szamotulska, Alison Macfarlane, Sophie Alexander, Henrique Barros, Mika Gissler, Béatrice Blondel, Jennifer Zeitlin, Gerald Haidinger, Rumyana Kolarova, Urelija Rodin, Theopisti Kyprianou, Petr Velebil, Laust Mortensen, Luule Sakkeus, Günther Heller, Nicholas Lack, Aris Antsaklis, István Berbik, Helga Sól Ólafsdóttir, Sheelagh Bonham, Marina Cuttini, Janis Misins, Jelena Isakova, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsøyr, Mihai Horga, Jan Cap, Natasa Tul, Francisco Bolúmar, Karin Gottvall, Karin Källén, Sylvan Berrut, Mélanie Riggenbach, Department of Health Sciences [Leicester], University of Leicester, The Netherlands Organisation for Applied Scientific Research (TNO), Tulane University, Perisur Foundation [Paramaribo, Suriname], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Research Institute of Mother and Child [Warsaw, Poland], Centre for Maternal and Child Health Research [London], City University London, Perinatal Epidemiology and Reproductive Health Unit [Brussels, Belgium], Université libre de Bruxelles (ULB), ISPUP-EPIUnit [Porto, Portugal], Universidade do Porto, National Institute for Health and Welfare [Helsinki], EU Union under the framework of the Health Programme and the Bridge Health Project., Euro-Peristat Scientific Committee : Gerald Haidinger, Sophie Alexander, Rumyana Kolarova, Urelija Rodin, Theopisti Kyprianou, Petr Velebil, Laust Mortensen, Luule Sakkeus, Mika Gissler, Béatrice Blondel, Günther Heller, Nicholas Lack, Aris Antsaklis, István Berbik, Helga Sól Ólafsdóttir, Sheelagh Bonham, Marina Cuttini, Janis Misins ,Jelena Isakova, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsøyr, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Natasa Tul, Francisco Bolúmar, Karin Gottvall, Karin Källén, Sylvan Berrut, Mélanie Riggenbach, Alison Macfarlane, PHILIBERT, Marianne, Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), and Universidade do Porto = University of Porto

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, Gestational Age, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Pregnancy, 030225 pediatrics, medicine, Humans, education, reproductive and urinary physiology, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Developed Countries, Gestational age, General Medicine, Stillbirth, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, [SDV] Life Sciences [q-bio], Europe, Clinical Practice, Population Surveillance, Relative risk, Gestation, Female, RG, business, Risk assessment, Live Birth, Cohort study
Abstract

International comparisons of stillbirth allow assessment of variations in clinical practice to reduce mortality. Currently, such comparisons include only stillbirths from 28 or more completed weeks of gestational age, which underestimates the true burden of stillbirth. With increased registration of early stillbirths in high-income countries, we assessed the reliability of including stillbirths before 28 completed weeks in such comparisons.In this population-based study, we used national cohort data from 19 European countries participating in the Euro-Peristat project on livebirths and stillbirths from 22 completed weeks of gestation in 2004, 2010, and 2015. We excluded countries without national data for stillbirths by gestational age in these periods, or where data available were not comparable between 2004 and 2015. We also excluded those countries with fewer than 10 000 births per year because the proportion of stillbirths at 22 weeks to less than 28 weeks of gestation is small. We calculated pooled stillbirth rates using a random-effects model and changes in rates between 2004 and 2015 using risk ratios (RR) by gestational age and country.Stillbirths at 22 weeks to less than 28 weeks of gestation accounted for 32% of all stillbirths in 2015. The pooled stillbirth rate at 24 weeks to less than 28 weeks declined from 0·97 to 0·70 per 1000 births from 2004 to 2015, a reduction of 25% (RR 0·75, 95% CI 0·65-0·85). The pooled stillbirth rate at 22 weeks to less than 24 weeks of gestation in 2015 was 0·53 per 1000 births and did not significantly changed over time (RR 0·97, 95% CI 0·80-1·16) although changes varied widely between countries (RRs 0·62-2·09). Wide variation in the percentage of all births occurring at 22 weeks to less than 24 weeks of gestation suggest international differences in ascertainment.Present definitions used for international comparisons exclude a third of stillbirths. International consistency of reporting stillbirths at 24 weeks to less than 28 weeks suggests these deaths should be included in routinely reported comparisons. This addition would have a major impact, acknowledging the burden of perinatal death to families, and making international assessments more informative for clinical practice and policy. Ascertainment of fetal deaths at 22 weeks to less than 24 weeks should be stabilised so that all stillbirths from 22 completed weeks of gestation onwards can be reliably compared.EU Union under the framework of the Health Programme and the Bridge Health Project.

Published
2018
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20. Neonatal Mortality Disparities by Gestational Age in European Countries.

Author

Sartorius V, Philibert M, Klungsoyr K, Klimont J, Szamotulska K, Drausnik Z, Velebil P, Mortensen L, Gissler M, Fresson J, Nijhuis J, Zhang WH, Källén K, Rihs TA, Tica V, Matthews R, Smith L, and Zeitlin J

Subjects
Humans, Cross-Sectional Studies, Infant, Newborn, Europe epidemiology, Infant, Female, Male, Health Status Disparities, Live Birth epidemiology, Infant Mortality trends, Gestational Age
Abstract

Importance: There are wide disparities in neonatal mortality rates (NMRs, deaths <28 days of life after live birth per 1000 live births) between countries in Europe, indicating potential for improvement. Comparing country-specific patterns of births and deaths with countries with low mortality rates can facilitate the development of effective intervention strategies., Objective: To investigate how these disparities are associated with the distribution of gestational age (GA) and GA-specific mortality rates., Design, Setting, and Participants: This was a cross-sectional study of all live births in 14 participating European countries using routine data compiled by the Euro-Peristat Network. Live births with a GA of 22 weeks or higher from 2015 to 2020 were included. Data were analyzed from May to October 2023., Exposures: GA at birth., Main Outcomes and Measures: The study investigated excess neonatal mortality, defined as a rate difference relative to the pooled rate in the 3 countries with the lowest NMRs (Norway, Sweden, and Finland; hereafter termed the top 3). The Kitagawa method was used to divide this excess into the proportion explained by the GA distribution of births and by GA-specific mortality rates. A sensitivity analysis was conducted among births 24 weeks' GA or greater., Results: There were 35 094 neonatal deaths among 15 123 428 live births for an overall NMR of 2.32 per 1000. The pooled NMR in the top 3 was 1.44 per 1000 (1937 of 1 342 528). Excess neonatal mortality compared with the top 3 ranged from 0.17 per 1000 in the Czech Republic to 1.82 per 1000 in Romania. Excess deaths were predominantly concentrated among births less than 28 weeks' GA (57.6% overall). Full-term births represented 22.7% of the excess deaths in Belgium, 17.8% in France, 40.6% in Romania and 17.3% in the United Kingdom. Heterogeneous patterns were observed when partitioning excess mortality into the proportion associated with the GA distribution vs GA-specific mortality. For example, these proportions were 9.2% and 90.8% in France, 58.4% and 41.6% in the United Kingdom, and 92.9% and 7.1% in Austria, respectively. These associations remained stable after removing births under 24 weeks' GA in most, but not all, countries., Conclusions and Relevance: This cohort study of 14 European countries found wide NMR disparities with varying patterns by GA. This knowledge is important for developing effective strategies to reduce neonatal mortality.

Published
2024
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