Documentation sheet
Definition of indicator
Calculation (numerator, denominator)
Additional underlying concepts
Relevant dimensions (subgroups)
Preferred data sources
Rationale
Data availability, quality and periodicity
References
Work to do
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Perinatal mortality The number of fetal deaths plus early neonatal deaths after live birth in a given year, per 1.000 live and stillbirths. |
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Calculation (numerator, denominator) (1) The number of fetal deaths and deaths in the early neonatal period (up to 6 completed days after birth) after live birth (weighting 500 grams or more) at or after 22 complete weeks of gestation in a given year, expressed per 1.000 live and stillbirths in the same year. (2) WHO recommendation for international comparisons is 1000 grams or more. |
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Additional underlying concepts Perinatal mortality death rate can be sub-divided by timing of death into fetal deaths and early neonatal deaths (at 0-6 days after live birth). WHO definition for international comparisons recommended: WHO calculates perinatal mortality for stillbirths and live births weighting 1 000 grams or more, to minimize the variation in registration criteria (some countries start the registration of fetal deaths from 24 or 28 weeks of gestation). OECD calculates perinatal mortality as the ratio of deaths of children within one week of birth (early neonatal deaths) plus foetal deaths of minimum gestation period 28 weeks or minimum foetal weight of 1000g, expressed per 1,000 births. WHO definitions: Live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered live-born. The number of live births includes all live births during the given calendar year, irrespective of registration of the date of birth. Fetal death is death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. |
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Relevant dimensions (subgroups) Country, year, sex. Also age of mother, birth weight, gestational age, plurality, and cause of death. |
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Birth or perinatal registries, hospital discharge data, perinatal surveys. |
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A sensitive measure of health in the perinatal period. Also important indicator for quality of perinatal health care, and preventive care. |
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Data availability, quality and periodicity Availability: WHO recommended: regularly updated based on national data. Some countries start the registration of fetal deaths from 24 or 28 weeks of gestation, which must be taken into account. Availability: Eurostat, OECD; regularly updated based on national data. Eurostat has no common definition. OECD and WHO have their own definitions, which differ from each other. Peristat has data for years 2000 and 2004. OECD notes: Some variations exist in the definitions for some countries, particularly with regard to fetal deaths, and as such care should be exercised when making comparisons between countries. Peristat-project notes: Differences in European legislation governing the lower limit for inclusion of fetal deaths makes it difficult to compare rates at low gestational ages (below 28 weeks of gestation). Fetal mortality is also particularly sensitive to underreporting at low gestational ages. Computing rates by gestational age and birthweight is necessary for deriving comparable indicators when registration practices diverge. Interpretation of fetal mortality must also take into consideration legislation, policies, and practices of induced abortions for congenital anomalies that are registered as fetal deaths. PERISTAT is conducting a feasibility study to test the availability of data for constructing indicator in the member states. This study will permit the scientific advisory committee to further refine the working list of indicators. Data from 24 weeks of gestation available for most countries. |
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Eurostat, |
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Data Presentations
More indicator information will follow in due time. |
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What the indicator is meant to measure. If not unambiguous, all acceptable alternatives are to be listed in numbered preference order. The final decision on preference order/numbering is to be made by ECHIM coregroup.
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How to calculate the indicator (method, numerator, denominator, etc), in the same preference order as above if more than one alternative.
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Why the indicator is measured the chosen way (prevalence, incidence, mortality, absolute numbers etc.)? Also reasons for the preferred definition and calculation details can be included here.
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Should the indicator be stratified by e.g. age, gender, socio-economic status and area
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The type of data source; in the same preference order as above (typically either register data or HIS/HES).
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Why is this indicator important, from the public health point of view. (For example: size or dynamics of the problem/issue, evidence of the relevance of the issue in public health terms (for determinants) or evidence of intervention effectiveness (for prevention or care issues)).
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The recommended data source (e.g. Eurostat, OECD, WHO, national registers or HIS/HES, project databases etc.), in the same preference order as above; some notes on the quality and availability of the data for the indicator. Eventually, also information on the availability in coutries, as derived from the ECHIM survey.
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References to original publications, websites, EHIS-question/naire, PHP projects, etc.
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What should be done to improve and complete this sheet. Eventually, this cell should be blank.
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