Neonatal Mortality Disparities by Gestational Age in European Countries-Reference-Cited by-同舟云学术

Neonatal Mortality Disparities by Gestational Age in European Countries

Published:2024-08-07 Issue:8 Volume:7 Page:e2424226
ISSN:2574-3805
Container-title:JAMA Network Open
language:en
Short-container-title:JAMA Netw Open

Author:

Sartorius Victor¹²,Philibert Marianne¹,Klungsoyr Kari³⁴,Klimont Jeannette⁵,Szamotulska Katarzyna⁶,Drausnik Zeljka⁷,Velebil Petr⁸⁹,Mortensen Laust¹⁰,Gissler Mika¹¹¹²¹³,Fresson Jeanne¹¹⁴,Nijhuis Jan¹⁵,Zhang Wei-Hong¹⁶,Källén Karin¹⁷,Rihs Tonia A.¹⁸,Tica Vlad¹⁹,Matthews Ruth²⁰,Smith Lucy²⁰,Zeitlin Jennifer¹, ,Farr Alex²¹,Alexander Sophie²¹,Racapé Judith²¹,Vandervelpen Gisèle²¹,Coutellas Vasos²¹,Kyprianou Theopisti²¹,Jirova Jitka²¹,Sakkeus Luule²¹,Abuladze Liili²¹,Blondel Béatrice²¹,Vilain Annick²¹,Durox Mélanie²¹,Heller Guenther²¹,Sziller István²¹,Gunnarsdóttir Johanna²¹,Sól Ólafsdóttir Helga²¹,Sikora Izabela²¹,O'Hara Sinead²¹,Kearns Karen²¹,Cuttini Marina²¹,Loghi Marzia²¹,Boldrini Rosaria²¹,Pappagal Marilena²¹,Marchetti Stefano²¹,Donati Serena²¹,Misins Janis²¹,Zile-Velika Irisa²¹,Isakova Jelena²¹,Lecomte Aline²¹,Pastore Jessica²¹,Álvarez Daniel²¹,Gatt Miriam²¹,Achterberg PW²¹,Broeders Lisa²¹,Akerkar Rupali²¹,Engjom Hilde²¹,Mierzejewska Ewa²¹,Barros Henrique²¹,Puscasiu Lucian²¹,Budianu Mihaela-Alexandra²¹,Cucu Alexandra²¹,Tica Vlad²¹,Lučovnik Miha²¹,Verdenik Ivan²¹,Fernandez Elorriaga Maria²¹,Zurriaga Oscar²¹,Recio Alcaide Adela²¹,Nyman Anastasia²¹,Macfarlane Alison²¹,Scott Sonya²¹,Monteath Kirsten²¹,Morgan Siobhan²¹,Thomas Craig²¹,Magill Sinead²¹,Ceely Greg²¹

Affiliation:

1. CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPe, INSERM, INRA, Université Paris Cité, Paris, France

2. Department of Neonatal Intensive Care, AP-HP, Hôpital Necker Enfants-Malades, Paris, France

3. Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway

4. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

5. Unit Demography and Health, Directorate Social Statistics, Statistics Austria, Vienna, Austria

6. Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland

7. Division of Public Health, Croatian Institute of Public Health, Zagreb, Croatia

8. Department of Obstetrics and Gynecology, Institute for the Care of Mother and Child, Prague, Czech Republic.

9. Department of Obstetrics and Gynecology, Third Faculty of Medicine, Charles University, Prague, Czech Republic

10. Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

11. Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland

12. Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden

13. Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden

14. Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques (Drees), Paris, France

15. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, MUMC+, Maastricht, the Netherlands

16. International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

17. Swedish National Board of Health and Welfare, Department of Analysis, Stockholm, Sweden

18. Federal Statistical Office (FSO), Neuchâtel, Switzerland

19. Faculty of Medicine, East European Institute for Reproductive Health, Academy of Romanian Scientists, University ‘Ovidius’ Constanţa, Constanța, Romania

20. Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, United Kingdom

21. for the Euro-Peristat Network

Abstract

ImportanceThere are wide disparities in neonatal mortality rates (NMRs, deaths &lt;28 days of life after live birth per 1000 live births) between countries in Europe, indicating potential for improvement. Comparing country-specific patterns of births and deaths with countries with low mortality rates can facilitate the development of effective intervention strategies.ObjectiveTo investigate how these disparities are associated with the distribution of gestational age (GA) and GA-specific mortality rates.Design, Setting, and ParticipantsThis was a cross-sectional study of all live births in 14 participating European countries using routine data compiled by the Euro-Peristat Network. Live births with a GA of 22 weeks or higher from 2015 to 2020 were included. Data were analyzed from May to October 2023.ExposuresGA at birth.Main Outcomes and MeasuresThe study investigated excess neonatal mortality, defined as a rate difference relative to the pooled rate in the 3 countries with the lowest NMRs (Norway, Sweden, and Finland; hereafter termed the top 3). The Kitagawa method was used to divide this excess into the proportion explained by the GA distribution of births and by GA-specific mortality rates. A sensitivity analysis was conducted among births 24 weeks’ GA or greater.ResultsThere were 35 094 neonatal deaths among 15 123 428 live births for an overall NMR of 2.32 per 1000. The pooled NMR in the top 3 was 1.44 per 1000 (1937 of 1 342 528). Excess neonatal mortality compared with the top 3 ranged from 0.17 per 1000 in the Czech Republic to 1.82 per 1000 in Romania. Excess deaths were predominantly concentrated among births less than 28 weeks’ GA (57.6% overall). Full-term births represented 22.7% of the excess deaths in Belgium, 17.8% in France, 40.6% in Romania and 17.3% in the United Kingdom. Heterogeneous patterns were observed when partitioning excess mortality into the proportion associated with the GA distribution vs GA-specific mortality. For example, these proportions were 9.2% and 90.8% in France, 58.4% and 41.6% in the United Kingdom, and 92.9% and 7.1% in Austria, respectively. These associations remained stable after removing births under 24 weeks’ GA in most, but not all, countries.Conclusions and RelevanceThis cohort study of 14 European countries found wide NMR disparities with varying patterns by GA. This knowledge is important for developing effective strategies to reduce neonatal mortality.

Publisher

American Medical Association (AMA)

Link

https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2822061/sartorius_2024_oi_240761_1722443319.77583.pdf

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