Document Detail

Analysis of perinatal mortality and its components: time for a change?
MedLine Citation:
PMID:  12225996     Owner:  NLM     Status:  MEDLINE    
Since the midtwentieth century, stillbirths (late fetal deaths) and early neonatal deaths have often been combined into a single category of "perinatal" deaths. In the past, such a combination was justified by the fact that asphyxia was a common cause of death during labor (intrapartum stillbirth) and shortly after birth and by geographic and temporal differences in classification of livebirths versus stillbirths. In more recent years, however, the etiologic determinants have diverged sharply, with many fewer early neonatal deaths caused by asphyxia and relatively many more caused by congenital anomalies. Moreover, the increasingly common stratification of pregnancy outcome measures by gestational age or birth weight leads to the use of an inappropriate denominator (total livebirths plus stillbirths within each gestational age or birth weight category) for denoting risk for the stillbirth component, because all unborn fetuses (including the majority of those not born within the specified gestational age or birth weight range) are at risk of being stillborn in that range. The authors suggest that, whenever possible, stillbirths and early neonatal deaths should be reported separately, with gestational age-specific risks of stillbirth based on all fetuses at risk, and that antepartum and intrapartum stillbirths be reported separately.
Michael S Kramer; Shiliang Liu; Zhongcheng Luo; Hongbo Yuan; Robert W Platt; K S Joseph;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of epidemiology     Volume:  156     ISSN:  0002-9262     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-12     Completed Date:  2002-09-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  493-7     Citation Subset:  IM    
Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
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MeSH Terms
Birth Weight
Congenital Abnormalities
Epidemiologic Studies*
Fetal Death / epidemiology*
Gestational Age
Infant Mortality / trends*
Infant, Newborn
Pregnancy Outcome*
Research Design
Terminology as Topic

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