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​Perinatal statistics: national vs. international criteria

Perinatal mortality rates can differ up to 50% depending on the definitions used to include a stillbirth. The criteria can be a minimum gestational age , a minimum birth weight, or a combination of both.

 
  • Previously, the World Health Organisation (WHO) - in the context of ICD9 – considered the birth weight as the first criteria to include a foetal death in the statistics : for national use, the WHO recommended to include in the  perinatal statistics  "… all live and death born children with a minimum birth weight of 500 g, or if this information was unknown, those with a pregnancy duration of minimum 22 weeks."  For international use, the WHO recommended to include : "… all live and death born children with a minimum birth weight of 1000 g, or if this information was unknown, those with a pregnancy duration of minimum 28 weeks ".

 

  • More recent definitions give priority to the gestational age as first criteria to register fetal deaths.
EURO-PERISTAT:
EURO-PERISTAT defines stillbirth as fetal death at or after 22 completed weeks of gestation.
 
Perinatal statistics for international use:
The definition of a stillbirth recommended by WHO for international comparison is a baby born with no signs of life at or after 28 weeks’ gestation.
 
  • In the SPMA we have adopted the following criteria:

- For the national statistics: we report fetal deaths at or after 22  completed weeks of gestation, or if gestational age unknown, at least with  a 500 g birth weight.

- For the international statistics: we report fetal deaths at or after 28  completed weeks of gestation, or if gestational age unknown, at least with  a 1000 g birth weight.

 
The different definitions are of no influence on the calculation of mortality rates with regard to later periods (neonatal, postneonatal and infant mortality). 
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