Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project. Issue 6 (30th December 2015)

• Record Type: Journal Article
• Authors: Zeitlin, Jennifer; Mortensen, Laust; Cuttini, Marina; Lack, Nicholas; Nijhuis, Jan; Haidinger, Gerald; Blondel, Béatrice; Hindori-Mohangoo, Ashna D
• Other Names: author non-byline.; Alexander Sophie author non-byline.; Pavlou Pavlos author non-byline.; Velebil Petr author non-byline.; Andersen Anne-Marie Nybo author non-byline.; Sakkeus Luule author non-byline.; Gissler Mika author non-byline.; Antsaklis Aris author non-byline.; Berbik István author non-byline.; Ólafsdóttir Helga Sól author non-byline.; Bonham Sheelagh author non-byline.; Misins Janis author non-byline.; Jaselioniene Jone author non-byline.; Wagener Yolande author non-byline.; Gatt Miriam author non-byline.; van der Pal Karin author non-byline.; Klungsoyr Kari author non-byline.; Szamotulska Katarzyna author non-byline.; Barros Henrique author non-byline.; Horga Mihai author non-byline.; Cap Jan author non-byline.; Tul Mandić Natasa author non-byline.; Bolúmar Francisco author non-byline.; Gottvall Karin author non-byline.; Berrut Sylvie author non-byline.; Macfarlane Alison author non-byline.; Delnord Marie author non-byline.; Hindori-Mohangoo Ashna author non-byline.
• Is Part Of: Journal of epidemiology and community health. Volume 70:Issue 6(2016)
• Page Start: 609
• Page End: 615
• Publication Date: 2015-12-30
• Subjects: PERINATAL EPIDEMIOLOGY -- NEONATAL -- REPRODUCTIVE HEALTH -- Health inequalities; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2015-207013
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Methods: Data about live births, stillbirths and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating risk ratios (RR) for stillbirth, neonatal mortality and preterm birth rates in 2010 vs 2004. We used meta-analysis techniques to derive pooled RR using random-effects models overall, by GA subgroups and by mortality level in 2004. Results: Between 2004 and 2010, stillbirths declined by 17% (95% CI 10% to 23%), with a range from 1% to 39% by country. Neonatal mortality declined by 29% (95% CI 23% to 35%) with a range from 9% to 67%. Preterm birth rates did not change: 0% (95% CI −3% to 3%). Mortality declines were of a similar magnitude at all GA; mortality levels in 2004 were not associated with RRs. Conclusions: Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum.