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World Health Forum. 1994;15(1):85-7; discussion 87-8.

How can infant and perinatal mortality rates be compared internationally?

Author information

1
Head of the School of Health Services Management, University of New South Wales, Kensington, Australia.

Abstract

Much of the confusion surrounding international comparisons of infant and perinatal mortality rates could be removed if single definitions of live birth and fetal death were universally adopted. Suggestions as to how this might be achieved are made below.

PIP:

Although infant and perinatal mortality rates are important indicators of health status, it is difficult to make valid international comparisons because of the great diversity of definitions of a live birth or a fetal death. In the 9th revision of the international classification of diseases, live birth is defined as the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of 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. The above definition of live birth is unsatisfactory, because many aborted fetuses weighing 200-300 grams or less may move slightly after birth or have a transient heartbeat, even though gestation was less than 22 weeks. Also in the 9th revision, fetal death (stillbirth) is defined as death prior to the complete expulsion from its mother of a product of conception, irrespective of the duration of pregnancy; indicated by the fact that the fetus does not breathe or show any other evidence of life. The following new definitions are suggested. Live birth is the complete expulsion from its mother of a product of conception weighing 500 grams or more, irrespective of the duration of the pregnancy, which breathes or shows any other evidence of life. If a product of conception weighing less than 500 grams shows evidence of life 24 hours after birth, it should be considered as a live birth. When birth weight is unavailable, the gestational age (22 weeks) or body length corresponding to 500 grams should be used. Similarly, fetal death (stillbirth) is death prior to the complete expulsion or extraction from its mother of a product of conception weighing 500 grams or more, irrespective of the duration of the pregnancy.

PMID:
8141989
[Indexed for MEDLINE]

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