Impact of stillbirths on international comparisons of preterm birth rates: a secondary analysis of the WHO multi-country survey of Maternal and Newborn Health

Impact of stillbirths on international comparisons of preterm birth rates: a secondary analysis of the WHO multi-country survey of Maternal and Newborn Health

Author Morisaki, N. Google Scholar
Ganchimeg, T. Google Scholar
Vogel, J. P. Google Scholar
Zeitlin, J. Google Scholar
Cecatti, J. G. Google Scholar
Souza, J. P. Google Scholar
Pileggi Castro, C. Google Scholar
Torloni, M. R. Autor UNIFESP Google Scholar
Ota, E. Google Scholar
Mori, R. Google Scholar
Dolan, S. M. Google Scholar
Tough, S. Google Scholar
Mittal, S. Google Scholar
Bataglia, V. Google Scholar
Yadamsuren, B. Google Scholar
Kramer, M. S. Google Scholar
Abstract Objective To evaluate the extent to which stillbirths affect international comparisons of preterm birth rates in low-and middle-income countries. Design Secondary analysis of a multi-country cross-sectional study. Setting 29 countries participating in the World Health Organization Multicountry Survey on Maternal and Newborn Health. Population 258 215 singleton deliveries in 286 hospitals. Methods We describe how inclusion or exclusion of stillbirth affect rates of preterm births in 29 countries. Main outcome measures Preterm delivery. Results In all countries, preterm birth rates were substantially lower when based on live births only, than when based on total births. However, the increase in preterm birth rates with inclusion of stillbirths was substantially higher in low Human Development Index (HDI) countries [ median 18.2%, interquartile range (17.2-34.6%)] compared with medium (4.3%, 3.0-6.7%), and high-HDI countries (4.8%, 4.4-5.5%). Conclusion Inclusion of stillbirths leads to higher estimates of preterm birth rate in all countries, with a disproportionately large effect in low-HDI countries. Preterm birth rates based on live births alone do not accurately reflect international disparities in perinatal health

thus improved registration and reporting of stillbirths are necessary.
Keywords Global health
low income country
perinatal health
preterm birth
stillbirth
Language English
Sponsor UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction
WHO
USAID
Ministry of Health, Labor and Welfare of Japan
Date 2017
Published in Bjog-An International Journal Of Obstetrics And Gynaecology. Hoboken, v. 124, n. 9, p. 1346-1354, 2017.
ISSN 1470-0328 (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 1346-1354
Origin http://dx.doi.org/10.1111/1471-0528.14548
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000405939600012
URI http://repositorio.unifesp.br/handle/11600/51483

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