Promoting healthy pregnancy and safe childbirth is a goal of all European health care systems. Despite progress in recent decades, mothers and their babies are still very much at risk during the perinatal period, which covers pregnancy, delivery, and the postpartum.
The European Perinatal Health Report released by the EURO-PERISTAT project is the most comprehensive report on the subject to date and takes a new approach to health reporting. Instead of comparing countries on single indicators like infant mortality (the ‘report card’ or ‘league table’ approach), the report paints a fuller picture by presenting data about mortality, low birthweight and preterm birth alongside data about health care and other factors that can affect the outcome of pregnancy. It also illustrates differences in the ways that data are collected, and explains how these can affect comparisons between countries.
The 280-page report was a major feat of collaboration between researchers and official statisticians in Europe. It contains data on EURO-PERISTAT indicators for the year 2004 from 25 participating EU member states and Norway. It also contains data from three other European projects: Surveillance of Cerebral Palsy in Europe (SCPE), European Surveillance of Congenital Anomalies (EUROCAT), and the European Information System to Monitor Short and Long-Term Morbidity to Improve Quality of Care and Patient Safety for Very-Low-Birth-Weight Infants (EURONEOSTAT).
Outcomes differ widely between the countries of Europe. No country tops every list. Understanding the reasons behind these differences can provide the insights needed for prevention and improvement.
•Fetal mortality/ stillbirth rates: The cutoff for these varies between countries. When a definition excluding all births before 28 completed weeks of gestation is used, the fetal mortality rate in 2004 ranged from around 2.0 per 1000 births in the Slovak Republic and Finland to 4.9 in Latvia and France. The Netherlands and Scotland also had rates of over 4.0 per 1000.
•Neonatal mortality: Deaths from 0 to 27 days among babies born alive. These ranged from around 2.0 per 1000 live births in Cyprus, Sweden and Norway to 4.6 in Lithuania and 5.7 in Latvia. Countries with rates over 4.0 per 1000 included Estonia, Hungary, Malta, and Poland.
•Congenital Anomalies: Although the majority of fetuses affected by a congenital anomaly survive the first year of life, congenital anomaly is a major contributor to fetal and neonatal deaths. Perinatal mortality associated with congenital anomaly varies from 0.2 to 2.6 per 1,000 births, and termination of pregnancy for fetal anomaly varies from 0 to 10.7 per 1,000 births
•Low birthweight: The percentage of live born babies who weighed less than 2500 g. This varied from 4.2 to 4.3% in Estonia, Finland, and Sweden to 8.5% in Greece, 8.3% in Hungary, and 7.4% in Spain. A geographical pattern characterised the incidence of low birthweight in Europe, with lower rates in the more northerly countries.
•Preterm birth: The percentage of live births occurring before 37 completed weeks of gestation. This rate ranged from 11.4% in Austria and 8.9% in Germany to 5.3% in Lithuania, 5.5% in Ireland 5.6% in Finland 5.7% in Latvia.
•Maternal mortality ratios: These vary widely, partly because they are based on very small numbers of deaths and partly reflecting differences in health care, which need fuller investigation.
•Cerebral palsy: which can be associated with adverse perinatal events, affects an estimated one child out of 500. Even when a common definition is used, cerebral palsy rates in Europe vary from 1.04 to 2.50 children with cerebral palsy per 1,000 children born alive.
Obstetric practice varies widely in Europe. This raises questions about what level of obstetric intervention is the most appropriate.
•Rates of caesarean section ranged from 14% in the Netherlands and 15% in Slovenia to 33% in Portugal and 38% in Italy.
•Instrumental delivery rates ranged from fewer than 3% of all deliveries in Ireland, the Slovak Republic, and Slovenia to more than 12% in Portugal and in the Valencia region of Spain.
•Labour was induced fewer than 9% of all deliveries in Lithuania and Estonia, but more than 30% in Northern Ireland (UK) and Malta.
•Episiotomy rates ranged from less than 10% of vaginal deliveries in Denmark, 14% in Wales (UK), and 16% in England (UK) to 82% in Valencia (Spain), 63% in Flanders (Belgium), and 52% in Italy.
FUTURE CONCERNS: the need for better data and a system for continuous reporting. To improve perinatal health, we need the right tools to assess problems and their causes. We also need to monitor the impact of policy initiatives over time. This report is a first step towards providing Europe with such a tool.
Data to construct the EURO-PERISTAT core indicators are available in almost all countries, but there are still many gaps. Many countries need to improve the range and quality of the data they collect. Many countries have little or no data on maternal morbidity, care during pregnancy, and the associations between social factors and health outcomes.
This report is a snapshot for the year 2004. It needs to be repeated to build up a picture of changes over time. EURO-PERISTAT aims to develop sustainable perinatal health reporting. The full value of having common and comparable indicators in Europe will be realised when this exercise becomes continuous and assessment of progress is possible.
Séverine Ciancia | alfa
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
20.10.2017 | Information Technology
20.10.2017 | Materials Sciences
20.10.2017 | Interdisciplinary Research