Perinatal health monitoring through a European lens: Eight lessons from the Euro-Peristat report on 2015 births

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...

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

Background. 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...

Can the Apgar Score be Used for International Comparisons of Newborn Health?

Background: The Apgar score has been shown to be predictive of neonatal mortality in clinical and population studies, but has not been used for international comparisons. We examined population-level distributions in Apgar scores and associations with neonatal mortality in Europe. Methods: Aggregate data on the 5 minute Apgar score for live...

Variations in very preterm births rates in 30 high-income countries: Are valid international comparisons possible using routine data?

OBJECTIVE: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons. DESIGN: Population-based study. SETTING: Twenty-seven European countries, the United States, Canada and Japan in 2010. POPULATION: A total of 9 376 252 singleton births...

Variations in rates of severe perineal tears and episiotomies in 20 European countries: A study based on routine national data in Euro-Peristat Project

Introduction: Rates of severe perineal tears and episiotomies are indicators of obstetrical quality of care, but their use for international comparisons is complicated by difficulties with accurate ascertainment of tears and uncertainties regarding the optimal rate of episiotomies. We compared rates of severe perineal tears and episiotomies in...

Socioeconomic inequalities in stillbirth rates in Europe: measuring the gap using routine data from the Euro-Peristat Project

Background: Previous studies have shown that socioeconomic position is inversely associated with stillbirth risk, but the impact on national rates in Europe is not known. We aimed to assess the magnitude of social inequalities in stillbirth rates in European countries using indicators generated from routine monitoring systems. Methods:...

Linking databases on perinatal health: A review of the literature and current practices in Europe

Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought to assess the extent to which data are linked...

Varying gestational age patterns in cesarean delivery: An international comparison

Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and low risk pregnancies based on new scientific...

Preterm birth time trends in Europe: A study of 19 countries

Objective To investigate time trends in preterm birth in Europe by multiplicity, gestational age, and onset of delivery. Design Analysis of aggregate data from routine sources. Setting Nineteen European countries. Population Live births in 1996, 2000, 2004, and 2008. Methods Annual risk ratios of preterm birth in each country were estimated with...

International Comparisons of Fetal and Neonatal Mortality Rates in High-Income Countries: Should Exclusion Thresholds Be Based on Birth Weight or Gestational Age?

Background:Fetal and neonatal mortality rates are essential indicators of population health, but variations in recording of births and deaths at the limits of viability compromises international comparisons. The World Health Organization recommends comparing rates after exclusion of births with a birth weight less than 1000 grams, but many...

European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010

What about the mothers? An analysis of maternal mortality and morbidity in perinatal health surveillance systems in Europe

Objective To assess capacity to develop routine monitoring of maternal health in the European Union using indicators of maternal mortality and severe morbidity. Design Analysis of aggregate data from routine statistical systems compiled by the EURO-PERISTAT project and comparison with data from national enquiries. Setting Twenty-five countries...

Gestational age patterns of fetal and neonatal mortality in Europe: results from the Euro-Peristat Project