Neonatal Mortality Disparities by Gestational Age in European Countries.
Victor Sartorius1,2, Marianne Philibert1, Kari Klungsoyr3,4
1CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPe, INSERM, INRA, Université Paris Cité, Paris, France.
JAMA Network Open
|August 7, 2024
Summary
Neonatal mortality rates vary widely across European countries, with significant differences linked to gestational age distribution and mortality. Understanding these patterns is key to developing targeted interventions for reducing infant deaths.
Area of Science:
- Perinatal epidemiology
- Public health
- Neonatal care
Background:
- Significant disparities exist in neonatal mortality rates (NMRs) across European countries.
- Comparing high-mortality countries with low-mortality benchmarks can inform intervention strategies.
Purpose of the Study:
- To investigate the association between neonatal mortality disparities and gestational age (GA) distribution.
- To analyze GA-specific mortality rates in relation to overall NMR variations.
Main Methods:
- Cross-sectional study using routine data from 14 European countries (2015-2020).
- Analysis of live births (GA ≥ 22 weeks) and neonatal deaths.
- Utilized the Kitagawa method to partition excess mortality by GA distribution and GA-specific rates.
Main Results:
- Overall NMR was 2.32 per 1000 live births; excess mortality varied significantly by country.
- Excess deaths were concentrated in preterm births (<28 weeks GA), but term births also contributed.
- Proportions of excess mortality attributed to GA distribution versus GA-specific mortality showed heterogeneous patterns across countries.
Conclusions:
- Wide NMR disparities persist in Europe, influenced by varying GA distributions and GA-specific mortality.
- These findings highlight the need for tailored strategies to reduce neonatal mortality.
- Understanding GA-related patterns is crucial for effective public health interventions in neonatal care.
