Field, D., Draper, E. S., Fenton, A., Papiernik, E. (Emile), Zeitlin, J., Blondel, Béatrice, Cuttini, M., Maier, R. F., Weber, T., Carrapato, M., Kollee, L., Gadzin, J. and Van Reempts, P. (2009) Rates of very preterm birth in Europe and neonatal mortality rates. Archives of Disease in Childhood - Fetal and Neonatal Edition, Vol.94 (No.4). F253-F256. ISSN 1359-2998

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Abstract

Objective: To estimate the influence of variation in the
rate of very preterm delivery on the reported rate of
neonatal death in 10 European regions.
Design: Comparison of 10 separate geographically
defined European populations, from nine European
countries, over a 1-year period (7 months in one region).
Participants: All births that occurred between 22
+0
and
31
+6
weeks of gestation in 2003.
Main outcome measure: Neonatal death rate adjusted
for rate of delivery at this gestation.
Results: Rate of delivery of all births at 22
+0
–31
+6
weeks
of gestation and live births only were calculated for each
region. Two regions had significantly higher rates of very
preterm delivery per 1000 births: Trent UK (16.8, 95% CI
15.7 to 17.9) and Northern UK (17.1, 95% CI 15.6 to
18.6); group mean 13.2 (95% CI 12.9 to 13.5). Four
regions had rates significantly below the group average:
Portugal North (10.7, 95% CI 9.6 to 11.8), Eastern and
Central Netherlands (10.6, 95% CI 9.7 to 11.6), Eastern
Denmark (11.2, 95% CI 10.1 to 12.4) and Lazio in Italy
(11.0, 95% CI 10.1 to 11.9). Similar trends were seen in
live birth data. Published rates of neonatal death for each
region were then adjusted by applying (a) a standardised
rate of very preterm delivery and (b) the existing death
rate for babies born at this gestation in the individual
region. This produced much greater homogeneity in terms
of neonatal mortality.
Conclusions: Variation in the rate of very preterm
delivery has a major influence on reported neonatal death
rates.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Archives of Disease in Childhood - Fetal and Neonatal Edition
Publisher:	B M J Group
ISSN:	1359-2998
Official Date:	2009
Volume:	Vol.94
Number:	No.4
Page Range:	F253-F256
Identification Number:	10.1136/adc.2008.150433
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/46367

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