The health of newborn babies and their mothers are key indicators of the health and wellbeing of populations. Although stillbirth and infant mortality rates have fallen substantially in recent decades, there are still major challenges to achieving the goal of providing an optimal start in life for all children and families. Looking at the health of newborn babies and their mothers through a European lens gives us insight into these challenges and possible ways of tackling them. One of the obstacles to making comparisons between European countries is that they collect their national statistics in different ways, so it is difficult to do valid comparisons.
The European Perinatal Health Report is the fourth report produced by the Euro-Peristat collaboration, which was established to deal with this problem. To produce the report, over 100 participating members in all the current EU member states and Iceland, Norway and Switzerland contributed data from their national statistical systems. Euro-Peristat is coordinated by Inserm, the French National Institute of Health and Medical Research. Euro-Peristat has defined a set of 10 core and 20 recommended indicators and uses them to monitor perinatal health in Europe. This new report is based on data for over five million births in the year 2015 compiled from public national statistical systems to construct all 10 core indicators and two of the 20 recommended indicators. Euro-Peristat works to produce high quality, comparable indicators by using common inclusion criteria and categories, followed by extensive data checking with the active involvement of network members from all participating countries. Comparisons were made with data for births in 2010 from Euro-Peristat's previous report. REPORT HIGHLIGHTS
REPORT HIGHLIGHTS
Stillbirth and neonatal mortality rates were lower compared with 2010 in Europe overall, but both the rates and the extent of the decrease varied widely between countries
Stillbirths
Usually only stillbirths after 28 or more weeks of pregnancy are included in international comparisons
Neonatal mortality
Neonatal deaths are deaths of babies before 28 days after live birth. Babies born before 22 weeks of pregnancy were excluded in line with international definitions
Some of this variation in neonatal mortality rates is related to differences in national policies about termination of pregnancy for fetal anomalies.
Infant mortality
Infant deaths are deaths of babies under a year after live birth. Babies born before 22 weeks of pregnancy were excluded in line with international definitions
Rates of preterm birth and low birthweight did not change overall, but there were wide geographical variations
Low birth weight
Low birth weight is defined as a birth weight under 2500 grams
Preterm birth
Preterm birth is birth before 37 completed weeks of pregnancy
Poor quality statistics continue to hamper European surveillance of maternal deaths
Maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy for any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
Differences in mode of delivery have widened, with caesarean section rates rising to over 40% in some countries
There has been an increase since 2010 in the relative size of many subgroups of childbearing women at higher risk of adverse outcome and this presents a common challenge.
Multiple births
Age at childbirth
Obesity
Smoking in pregnancy
Europe needs continuous and more complete monitoring
This report illustrates the extent to which it is feasible to compile comparable data about the health of mothers and babies and the importance of doing so. The set of Euro-Peristat indicators should represent minimum standards for national reporting, but many countries do not have all the data required. Data availability overall is good for the core indicators, but tabulations by subgroup are not available for all indicators. Many countries were unable to provide data on maternal smoking or prepregnancy body mass index, although these are needed to evaluate policies to improve population health.
This report includes data for 2015 for all 10 Euro-Peristat core indicators, but only two of the 20 recommended indicators. In the absence of funding for a full data collection exercise, the network decided to collect core indicators to be able to update essential basic information related to the health of babies and their mothers. We hope that in the future, sustainable funding for data collection will make it possible to compile the full set of Euro-Peristat indicators related to the wider set of health and healthcare factors as well as social determinants of health, such as maternal education and country of birth. These data are needed to address the high priority questions of health inequalities on a European scale.
Finally, this report is based on data for two single years five years apart and therefore suffers from a lack of continuous time series data. We cannot accurately describe trends in the indicators without annual data. Many of the participating countries have relatively small populations and rates fluctuate from year to year. A goal for current health information initiatives should be to create a sustainable structure and a funding stream to support collection, data cleaning and validation, and analysis of data from routine statistical systems in European countries on an annual basis.
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