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Abstract

Objective

To explore term mortality rates in relation to rates of early‐term birth (gestational ages 37 + 0 to 38 + 6 weeks), regarded as a proxy indicator of practices of elective birth by induction or caesarean.

Design

Ecological study using national birth data.

Setting

28 European countries.

Population

Births ≥ 37 weeks between 2015 and 2020.

Methods

Aggregated data on live and stillbirths by completed week of gestation was compiled from routine sources in the Euro‐Peristat network. Countries were divided into three groups based on their percentages of early‐term births using terciles (high, medium and low) and mortality rates were compared between groups with random‐effects meta‐analysis of proportions.

Main Outcome Measures

Stillbirths (antepartum or intrapartum fetal death) and perinatal death (stillbirth or early neonatal death) per 1000 total births ≥ 37 weeks.

Results

Early‐term birth rates ranged from 17.8% (Iceland) to 49.1% (Cyprus), with terciles being < 21%, 21%–27%, and > 27%. Post‐term birth rates were low in countries with higher early‐term birth rates. The pooled stillbirth rate ≥ 37 weeks was 1.28 per 1000 total births (95% CI: 1.13–1.46) in the lowest tercile and 1.05 (95% CI: 0.95–1.16) in the highest (p = 0.05), but prediction intervals were wide reflecting heterogeneity within groups. No evidence of difference was seen between perinatal mortality rates by tercile (p = 0.71).

Conclusion

On average, the stillbirth rate was lower in countries where early‐term birth rates were highest, but no difference was found in perinatal mortality rates. Heterogeneity was high within groups.

Publication Type:	Article
Publisher Keywords:	early‐term birth, neonatal death, perinatal death, stillbirth
Subjects:	H Social Sciences > HQ The family. Marriage. Woman R Medicine > R Medicine (General) R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services R Medicine > RT Nursing
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:	Symplectic Administrator

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