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Published on: November 20, 2015
Early Neonatal Mortality among Babies Born with Spina Bifida in Finland (2000-2014)
Vijaya Kancherla1, Sanjida Mowla1, Sari Räisänen2
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Insights
Early neonatal mortality for spina bifida births in Finland is 7.2%, with a concerning increasing trend observed between 2000 and 2014. Factors like low gestational age, syndrome occurrence, and advanced maternal age significantly elevate this risk.
Area of Science:
- Perinatal epidemiology
- Public health
- Congenital anomaly research
Background:
- Spina bifida is a complex congenital anomaly with significant impact on neonatal outcomes.
- Understanding early neonatal mortality trends and associated factors is crucial for improving infant survival rates.
Purpose of the Study:
- To investigate early neonatal mortality risk and temporal trends in spina bifida-affected live births in Finland.
- To identify infant and maternal factors associated with early neonatal mortality in this population.
Main Methods:
- Population-based data linkage of national registers in Finland (2000-2014).
- Analysis of early neonatal mortality (death within 0-6 days) using Poisson regression for trend analysis.
- Logistic regression to assess associations between infant/maternal factors and mortality.
Main Results:
- 7.2% of live-born spina bifida cases experienced early neonatal death.
- A significant increasing trend in early neonatal mortality was observed from 2000 to 2014 (p < 0.0001).
- Low gestational age, occurrence as part of a syndrome, and advanced maternal age (≥35 years) were associated with increased mortality risk.
Conclusions:
- Finland's spina bifida population faces high early neonatal mortality with an upward trend over 15 years.
- Specific infant (gestational age, syndrome status) and maternal (age) factors are linked to increased mortality.
- Future research should consider pooling Nordic data for larger sample sizes and multivariable analyses.
Objective:
We examined early neonatal mortality risk, temporal trends, and selected infant and maternal factors associated with early neonatal mortality among all spina bifida-affected live births in Finland.
Study Design:
We linked multiregistry population-based data from the national registers in Finland for infants born with spina bifida from 2000 to 2014. Early neonatal mortality was defined as death in 0 to 6 days after birth. Early neonatal mortality risk and 95% confidence intervals (CI) was estimated by using the Poisson approximation of binomial distribution. Poisson regression was used to examine temporal trend in early neonatal mortality from 2000 to 2014 for spina bifida cases and all births in Finland. Selected infant and maternal characteristics were compared between cases that experienced early neonatal mortality and cases that did not. Exact logistic regression was used to estimate unadjusted odds ratios (uORs) and 95% confidence intervals (CIs).
Results:
A total of 181 babies were born alive with spina bifida in Finland during the study period; 61% had isolated spina bifida. Pooling all study years, 7.2% (95% CI: 4.2-12.4%) of all live-born cases experienced early neonatal death. There was a significant increase in early neonatal mortality among spina bifida births over the study period (p < 0.0001). Low gestational age (<37 weeks; uOR = 6.96; 95% CI: 1.86-29.01), cases occurring as a part of a syndrome (uOR = 125.67; 95% CI: 14.90 to >999.999), and advanced maternal age at gestation (≥35 years; uOR = 5.33; 95% CI: 1.21-21.87) were positively associated with early neonatal mortality.
Conclusion:
Using national data from Finland, we found high early neonatal mortality with increasing trend over birth period spanning 15 years (2000-2014), and unadjusted positive associations with some infant and maternal factors. Future studies should pool data from Nordic countries to increase study size allowing multivariable analysis.
Key Points:
· Early neonatal mortality in babies affected by spina bifida is 7% in Finland.. · Early neonatal mortality trend showed a significant increase from 2000 to 2014.. · Low gestational age, syndrome case status, and advanced maternal age increased early neonatal mortality risk in spina bifida..
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