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Main arrow Archive of previous Issues arrow 3 2013 (31) arrow Pregnancy outcomes and perinatal losses in the context of new birth criteria
Pregnancy outcomes and perinatal losses in the context of new birth criteria Print
Tuesday, 09 July 2013

Summary. In April 2012, Russia introduced new birth criteria - birth weight 500 grams and 22 weeks of gestation. According to this criteria termination of pregnancy at 22-27 weeks of gestation that used to be termed as "late abortion" before 2011 should be considered and registered as extremely premature birth starting April 2012. This reform has been accompanied by reorganization of outcomes of registered pregnancies - births and abortions as well as the number of births and deaths by body weight.

Objective of the study was to determine changes in the pregnancy outcomes structure and perinatal situation in the context of new birth criteria.

Methods and information sources included comparison of official statistics from Federal Statistic Monitoring forms #13, #14 and #32 for 2011-2012.

Results and conclusions include that the number of pregnancies terminated at 22-27 weeks of gestation in 2012 decreased by 42% from 16336 in 2011 to 9639. The share of terminated pregnancies at 22-27 weeks of gestation out of all registered pregnancies (births and abortions) decreased from 0.60% to 0.34%.

Share of birth weights 500-999 grams ("fetus" according to the previous terminology when termination of pregnancy at 22-27 weeks of gestation was considered as an abortion) decreased from 0.88% out of the number of live and still births in 2011 to 0.53% in 2012. At the same time the share of "extremely low birth weight" 1000-1499 grams increased by 20.5% from 0.64% to 0.73% out of the number of all births confirming underreporting of this weight category in the previous years; this weight category was pinged in the group of birth weight under 1000 grams that was not counted by the infant and perinatal mortality statistics.

Inverse change in 2012 in the share of birth weight 1000-1499 grams (increase) and birth weight under 1000 grams (decrease) reflects a fundamental change in the approach towards registration of births, deaths and still births with birth weight 500-999 grams, that are now registered on the same basis as other birth weight categories under 1000 grams.

In 2012 perinatal mortality rate in maternity obstetric facilities increased because of birth weights under 1000 grams and added up to 9.75 per 1000 live and still births (compared to 6.72 in 2011). However, if we compare similar indicators for birth weights "1000 grams and up" (not including birth weights under 1000 grams) we will see increase in still births in 2012 (from 4.62 in 2011 to 4,79) and perinatal mortality (from 6.72 to 6,82) that may suggest a more reliable registration of deaths under the new birth criteria.

Drastic changes in such a static biological parameter as gestational structure of pregnancy termination occurring within a year are conditioned by market factors - review of terms of terminated pregnancy according to new criteria of births and abortions.

Keywords: birth; preterm birth; abortion; late abortion; birth criteria; pregnancy outcome; extremely low birth weight neonates; perinatal mortality; still birth.

References

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