An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age
To explore international differences in the classification of births at extremely low gestation and the subsequent impact on the calculation of survival rates. We used national data on births at 22 to 25 weeks' gestation from the United States (2014; = 11 144), Canada (2009-2014; = 5668), the U...
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| Veröffentlicht in: | Pediatrics (Evanston) 2018-07, Vol.142 (1), p.1 |
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| container_title | Pediatrics (Evanston) |
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| creator | Smith, Lucy K Morisaki, Naho Morken, Nils-Halvdan Gissler, Mika Deb-Rinker, Paromita Rouleau, Jocelyn Hakansson, Stellan Kramer, Michael R Kramer, Michael S |
| description | To explore international differences in the classification of births at extremely low gestation and the subsequent impact on the calculation of survival rates.
We used national data on births at 22 to 25 weeks' gestation from the United States (2014;
= 11 144), Canada (2009-2014;
= 5668), the United Kingdom (2014-2015;
= 2992), Norway (2010-2014;
= 409), Finland (2010-2015;
= 348), Sweden (2011-2014;
= 489), and Japan (2014-2015;
= 2288) to compare neonatal survival rates using different denominators: all births, births alive at the onset of labor, live births, live births surviving to 1 hour, and live births surviving to 24 hours.
For births at 22 weeks' gestation, neonatal survival rates for which we used live births as the denominator varied from 3.7% to 56.7% among the 7 countries. This variation decreased when the denominator was changed to include stillbirths (ie, all births [1.8%-22.3%] and fetuses alive at the onset of labor [3.7%-38.2%]) or exclude early deaths and limited to births surviving at least 12 hours (50.0%-77.8%). Similar trends were seen for infants born at 23 weeks' gestation. Variation diminished considerably at 24 and 25 weeks' gestation.
International variation in neonatal survival rates at 22 to 23 weeks' gestation diminished considerably when including stillbirths in the denominator, revealing the variation arises in part from differences in the proportion of births reported as live births, which itself is closely connected to the provision of active care. |
| doi_str_mv | 10.1542/peds.2017-3324 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_487685</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A549608384</galeid><sourcerecordid>A549608384</sourcerecordid><originalsourceid>FETCH-LOGICAL-c593t-459e37b0047e6b5690644498814b8919830947dd01a999c53b1d6b4484f872623</originalsourceid><addsrcrecordid>eNp9ks1v1DAQxS0EokvhyhFZ4gCXLP625xil0Faq1AuUo-UkzpI2iUOcqPDf43R3WwkJTras3zy_mXkIvaVkS6Vgn0Zfxy0jVGecM_EMbSgBkwmm5XO0IYTTTBAiT9CrGG8JIUJq9hKdMDAARLANuskHfDnMfhrc3IbBdbgI_eimNoYBhwafeTf_wEXnYmybtnqAsJsxY3gOmEn83fu7-AGf-zgfFfKdf41eNK6L_s3hPEXfvnz-WlxkV9fnl0V-lVUS-JwJCZ7rMvnSXpVSAVFCCDCGitIABcMJCF3XhDoAqCQvaa1KIYxojGaK8VOU7XXjvR-X0o5T27vptw2utYenu3TzVhitjEw8_JMfp1A_FR0LKTfKaKPof_86a29yG6adXfrFUkm0MIn_uOeT8M8lzcf2bax817nBhyVaRqRUlGlYpd__hd6GJa2kWykDqVVD4cnAznXetkMV0uJ-zVXoOr_zNg22uLa5FKCI4UYkfrvnqynEOPnm0TIldk2PXdNj1_TYNT2p4N3BxlL2vn7Ej3HhfwBehLzI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2089726819</pqid></control><display><type>article</type><title>An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Smith, Lucy K ; Morisaki, Naho ; Morken, Nils-Halvdan ; Gissler, Mika ; Deb-Rinker, Paromita ; Rouleau, Jocelyn ; Hakansson, Stellan ; Kramer, Michael R ; Kramer, Michael S</creator><creatorcontrib>Smith, Lucy K ; Morisaki, Naho ; Morken, Nils-Halvdan ; Gissler, Mika ; Deb-Rinker, Paromita ; Rouleau, Jocelyn ; Hakansson, Stellan ; Kramer, Michael R ; Kramer, Michael S</creatorcontrib><description>To explore international differences in the classification of births at extremely low gestation and the subsequent impact on the calculation of survival rates.
We used national data on births at 22 to 25 weeks' gestation from the United States (2014;
= 11 144), Canada (2009-2014;
= 5668), the United Kingdom (2014-2015;
= 2992), Norway (2010-2014;
= 409), Finland (2010-2015;
= 348), Sweden (2011-2014;
= 489), and Japan (2014-2015;
= 2288) to compare neonatal survival rates using different denominators: all births, births alive at the onset of labor, live births, live births surviving to 1 hour, and live births surviving to 24 hours.
For births at 22 weeks' gestation, neonatal survival rates for which we used live births as the denominator varied from 3.7% to 56.7% among the 7 countries. This variation decreased when the denominator was changed to include stillbirths (ie, all births [1.8%-22.3%] and fetuses alive at the onset of labor [3.7%-38.2%]) or exclude early deaths and limited to births surviving at least 12 hours (50.0%-77.8%). Similar trends were seen for infants born at 23 weeks' gestation. Variation diminished considerably at 24 and 25 weeks' gestation.
International variation in neonatal survival rates at 22 to 23 weeks' gestation diminished considerably when including stillbirths in the denominator, revealing the variation arises in part from differences in the proportion of births reported as live births, which itself is closely connected to the provision of active care.</description><identifier>ISSN: 0031-4005</identifier><identifier>ISSN: 1098-4275</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2017-3324</identifier><identifier>PMID: 29899042</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Analysis ; Birth rates ; Birth weight ; Canada ; Classification ; Female ; Fetal Death ; Fetuses ; Finland ; Gestation ; Gestational Age ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Infants ; Japan ; Labor ; Maternal mortality ; Medicin och hälsovetenskap ; Mortality ; Neonates ; Norway ; Pediatrics ; Pregnancy ; Registries ; Stillbirth ; Survival ; Survival Rate ; Sweden ; United Kingdom ; United States ; Variation</subject><ispartof>Pediatrics (Evanston), 2018-07, Vol.142 (1), p.1</ispartof><rights>Copyright © 2018 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Jul 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-459e37b0047e6b5690644498814b8919830947dd01a999c53b1d6b4484f872623</citedby><cites>FETCH-LOGICAL-c593t-459e37b0047e6b5690644498814b8919830947dd01a999c53b1d6b4484f872623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29899042$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-150748$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:138687861$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, Lucy K</creatorcontrib><creatorcontrib>Morisaki, Naho</creatorcontrib><creatorcontrib>Morken, Nils-Halvdan</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Deb-Rinker, Paromita</creatorcontrib><creatorcontrib>Rouleau, Jocelyn</creatorcontrib><creatorcontrib>Hakansson, Stellan</creatorcontrib><creatorcontrib>Kramer, Michael R</creatorcontrib><creatorcontrib>Kramer, Michael S</creatorcontrib><title>An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>To explore international differences in the classification of births at extremely low gestation and the subsequent impact on the calculation of survival rates.
We used national data on births at 22 to 25 weeks' gestation from the United States (2014;
= 11 144), Canada (2009-2014;
= 5668), the United Kingdom (2014-2015;
= 2992), Norway (2010-2014;
= 409), Finland (2010-2015;
= 348), Sweden (2011-2014;
= 489), and Japan (2014-2015;
= 2288) to compare neonatal survival rates using different denominators: all births, births alive at the onset of labor, live births, live births surviving to 1 hour, and live births surviving to 24 hours.
For births at 22 weeks' gestation, neonatal survival rates for which we used live births as the denominator varied from 3.7% to 56.7% among the 7 countries. This variation decreased when the denominator was changed to include stillbirths (ie, all births [1.8%-22.3%] and fetuses alive at the onset of labor [3.7%-38.2%]) or exclude early deaths and limited to births surviving at least 12 hours (50.0%-77.8%). Similar trends were seen for infants born at 23 weeks' gestation. Variation diminished considerably at 24 and 25 weeks' gestation.
International variation in neonatal survival rates at 22 to 23 weeks' gestation diminished considerably when including stillbirths in the denominator, revealing the variation arises in part from differences in the proportion of births reported as live births, which itself is closely connected to the provision of active care.</description><subject>Analysis</subject><subject>Birth rates</subject><subject>Birth weight</subject><subject>Canada</subject><subject>Classification</subject><subject>Female</subject><subject>Fetal Death</subject><subject>Fetuses</subject><subject>Finland</subject><subject>Gestation</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Japan</subject><subject>Labor</subject><subject>Maternal mortality</subject><subject>Medicin och hälsovetenskap</subject><subject>Mortality</subject><subject>Neonates</subject><subject>Norway</subject><subject>Pediatrics</subject><subject>Pregnancy</subject><subject>Registries</subject><subject>Stillbirth</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Sweden</subject><subject>United Kingdom</subject><subject>United States</subject><subject>Variation</subject><issn>0031-4005</issn><issn>1098-4275</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1v1DAQxS0EokvhyhFZ4gCXLP625xil0Faq1AuUo-UkzpI2iUOcqPDf43R3WwkJTras3zy_mXkIvaVkS6Vgn0Zfxy0jVGecM_EMbSgBkwmm5XO0IYTTTBAiT9CrGG8JIUJq9hKdMDAARLANuskHfDnMfhrc3IbBdbgI_eimNoYBhwafeTf_wEXnYmybtnqAsJsxY3gOmEn83fu7-AGf-zgfFfKdf41eNK6L_s3hPEXfvnz-WlxkV9fnl0V-lVUS-JwJCZ7rMvnSXpVSAVFCCDCGitIABcMJCF3XhDoAqCQvaa1KIYxojGaK8VOU7XXjvR-X0o5T27vptw2utYenu3TzVhitjEw8_JMfp1A_FR0LKTfKaKPof_86a29yG6adXfrFUkm0MIn_uOeT8M8lzcf2bax817nBhyVaRqRUlGlYpd__hd6GJa2kWykDqVVD4cnAznXetkMV0uJ-zVXoOr_zNg22uLa5FKCI4UYkfrvnqynEOPnm0TIldk2PXdNj1_TYNT2p4N3BxlL2vn7Ej3HhfwBehLzI</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Smith, Lucy K</creator><creator>Morisaki, Naho</creator><creator>Morken, Nils-Halvdan</creator><creator>Gissler, Mika</creator><creator>Deb-Rinker, Paromita</creator><creator>Rouleau, Jocelyn</creator><creator>Hakansson, Stellan</creator><creator>Kramer, Michael R</creator><creator>Kramer, Michael S</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D93</scope></search><sort><creationdate>20180701</creationdate><title>An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age</title><author>Smith, Lucy K ; Morisaki, Naho ; Morken, Nils-Halvdan ; Gissler, Mika ; Deb-Rinker, Paromita ; Rouleau, Jocelyn ; Hakansson, Stellan ; Kramer, Michael R ; Kramer, Michael S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-459e37b0047e6b5690644498814b8919830947dd01a999c53b1d6b4484f872623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analysis</topic><topic>Birth rates</topic><topic>Birth weight</topic><topic>Canada</topic><topic>Classification</topic><topic>Female</topic><topic>Fetal Death</topic><topic>Fetuses</topic><topic>Finland</topic><topic>Gestation</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Japan</topic><topic>Labor</topic><topic>Maternal mortality</topic><topic>Medicin och hälsovetenskap</topic><topic>Mortality</topic><topic>Neonates</topic><topic>Norway</topic><topic>Pediatrics</topic><topic>Pregnancy</topic><topic>Registries</topic><topic>Stillbirth</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Sweden</topic><topic>United Kingdom</topic><topic>United States</topic><topic>Variation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, Lucy K</creatorcontrib><creatorcontrib>Morisaki, Naho</creatorcontrib><creatorcontrib>Morken, Nils-Halvdan</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Deb-Rinker, Paromita</creatorcontrib><creatorcontrib>Rouleau, Jocelyn</creatorcontrib><creatorcontrib>Hakansson, Stellan</creatorcontrib><creatorcontrib>Kramer, Michael R</creatorcontrib><creatorcontrib>Kramer, Michael S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Umeå universitet</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, Lucy K</au><au>Morisaki, Naho</au><au>Morken, Nils-Halvdan</au><au>Gissler, Mika</au><au>Deb-Rinker, Paromita</au><au>Rouleau, Jocelyn</au><au>Hakansson, Stellan</au><au>Kramer, Michael R</au><au>Kramer, Michael S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>142</volume><issue>1</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><issn>1098-4275</issn><eissn>1098-4275</eissn><abstract>To explore international differences in the classification of births at extremely low gestation and the subsequent impact on the calculation of survival rates.
We used national data on births at 22 to 25 weeks' gestation from the United States (2014;
= 11 144), Canada (2009-2014;
= 5668), the United Kingdom (2014-2015;
= 2992), Norway (2010-2014;
= 409), Finland (2010-2015;
= 348), Sweden (2011-2014;
= 489), and Japan (2014-2015;
= 2288) to compare neonatal survival rates using different denominators: all births, births alive at the onset of labor, live births, live births surviving to 1 hour, and live births surviving to 24 hours.
For births at 22 weeks' gestation, neonatal survival rates for which we used live births as the denominator varied from 3.7% to 56.7% among the 7 countries. This variation decreased when the denominator was changed to include stillbirths (ie, all births [1.8%-22.3%] and fetuses alive at the onset of labor [3.7%-38.2%]) or exclude early deaths and limited to births surviving at least 12 hours (50.0%-77.8%). Similar trends were seen for infants born at 23 weeks' gestation. Variation diminished considerably at 24 and 25 weeks' gestation.
International variation in neonatal survival rates at 22 to 23 weeks' gestation diminished considerably when including stillbirths in the denominator, revealing the variation arises in part from differences in the proportion of births reported as live births, which itself is closely connected to the provision of active care.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>29899042</pmid><doi>10.1542/peds.2017-3324</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Analysis Birth rates Birth weight Canada Classification Female Fetal Death Fetuses Finland Gestation Gestational Age Humans Infant Infant Mortality Infant, Newborn Infants Japan Labor Maternal mortality Medicin och hälsovetenskap Mortality Neonates Norway Pediatrics Pregnancy Registries Stillbirth Survival Survival Rate Sweden United Kingdom United States Variation |
| title | An International Comparison of Death Classification at 22 to 25 Weeks' Gestational Age |
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