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Perinatal mortality rates: adjusting for risk factor profile is essential
Judith Rankin1, Mark S Pearce, Ruth Bell
1School of Population & Health Sciences (Epidemiology & Public Health), University of Newcastle, Newcastle, UK. j.m.rankin@ncl.ac.uk
Paediatric and Perinatal Epidemiology
|January 27, 2005
Summary
Crude perinatal mortality rates can be inaccurate. Adjusting for factors like birthweight and maternal age provides a more reliable measure for comparing health outcomes between populations.
Area of Science:
- Perinatal Health
- Epidemiology
- Public Health
Background:
- Perinatal mortality is a key indicator of health and healthcare quality.
- The accuracy of traditional perinatal mortality measures is increasingly questioned.
- Crude rates often fail to account for crucial demographic and clinical factors.
Purpose of the Study:
- To evaluate the accuracy of crude perinatal mortality measures.
- To demonstrate the impact of population characteristics on these rates.
- To propose a standardized method for improved international comparisons.
Main Methods:
- Utilized data from the Northern Perinatal Mortality Survey.
- Analyzed late fetal losses, stillbirths, and infant deaths.
- Applied standardization techniques for factors affecting adverse pregnancy outcomes.
Main Results:
- Crude perinatal mortality measures show potential for significant inaccuracy.
- Failure to adjust for factors like birthweight, maternal age, plurality, and gender distorts comparisons.
- Standardization significantly alters the perceived trends in perinatal death causes.
Conclusions:
- Crude perinatal mortality rates require careful interpretation due to confounding factors.
- Standardization using a 'standard birth population' is recommended.
- This approach enhances the validity of direct comparisons of perinatal health between populations.