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Gestational Age Patterns of Fetal and Neonatal Mortality in Europe: Results from the Euro-Peristat Project

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dc.contributor.author Mohangoo, Ashna D. eng
dc.contributor.author Buitendijk, Simone E. eng
dc.contributor.author Szamotulska, Katarzyna eng
dc.contributor.author Chalmers, Jim eng
dc.contributor.author Irgens, Lorentz M. eng
dc.contributor.author Bolumar, Francisco eng
dc.contributor.author Nijhuis, Jan G. eng
dc.contributor.author Zeitlin, Jennifer eng
dc.date.accessioned 2012-02-27T14:12:18Z
dc.date.available 2012-02-27T14:12:18Z
dc.date.issued 2011-11-16 eng
dc.identifier.citation PLoS ONE 6(11): e24727 en
dc.identifier.issn 1932-6203 eng
dc.identifier.uri http://hdl.handle.net/1956/5649
dc.description.abstract Background: The first European Perinatal Health Report showed wide variability between European countries in fetal (2.6– 9.1%) and neonatal (1.6–5.7%) mortality rates in 2004. We investigated gestational age patterns of fetal and neonatal mortality to improve our understanding of the differences between countries with low and high mortality. Methodology/Principal Findings: Data on 29 countries/regions participating in the Euro-Peristat project were analyzed. Most European countries had no limits for the registration of live births, but substantial variations in limits for registration of stillbirths before 28 weeks of gestation existed. Country rankings changed markedly after excluding deaths most likely to be affected by registration differences (22–23 weeks for neonatal mortality and 22–27 weeks for fetal mortality). Countries with high fetal mortality $28 weeks had on average higher proportions of fetal deaths at and near term ($37 weeks), while proportions of fetal deaths at earlier gestational ages (28–31 and 32–36 weeks) were higher in low fetal mortality countries. Countries with high neonatal mortality rates $24 weeks, all new member states of the European Union, had high gestational age-specific neonatal mortality rates for all gestational-age subgroups; they also had high fetal mortality, as well as high early and late neonatal mortality. In contrast, other countries with similar levels of neonatal mortality had varying levels of fetal mortality, and among these countries early and late neonatal mortality were negatively correlated. Conclusions: For valid European comparisons, all countries should register births and deaths from at least 22 weeks of gestation and should be able to distinguish late terminations of pregnancy from stillbirths. After excluding deaths most likely to be influenced by existing registration differences, important variations in both levels and patterns of fetal and neonatal mortality rates were found. These disparities raise questions for future research about the effectiveness of medical policies and care in European countries. en
dc.language.iso eng eng
dc.publisher Public Library of Science eng
dc.rights Attribution CC BY eng
dc.rights.uri http://creativecommons.org/licenses/by/2.5/ eng
dc.title Gestational Age Patterns of Fetal and Neonatal Mortality in Europe: Results from the Euro-Peristat Project eng
dc.type Peer reviewed eng
dc.type Journal article eng
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800 eng
dc.rights.holder Copyright 2011 Mohangoo et al.
dc.type.version publishedVersion eng
bora.peerreviewed Peer reviewed eng
bibo.doi http://dx.doi.org/10.1371/journal.pone.0024727 eng
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0024727


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