Abstract
BackgroundThe objective of this survey was to explore the association between pregnancy complications and perinatal outcome from regionally total birth population.MethodsIn this prospectively collected data of complete birth registries from all level I-III hospitals in Huai’an in 2015, perinatal morbidity and mortality in relation to pregnancy complications and perinatal outcome were analyzed using international definitions. The results were compared with that of 2010 survey in the same region.ResultsOf 59,424 total births in the hospitals of level I (n = 85), II (16) and III (6), delivery rate was 30.4, 40.1 and 29.5%, and rates of pregnancy complications were 12.9, 9.8 and 21.1% (average 14.1%), with antenatal corticosteroids rate in < 37 gestational weeks being 17.3, 31.0 and 39.9% (mean 36.6%), respectively. The preterm birth rate was 0.6, 2.7 and 9.5% (mean 4.06%), and the composite rate of fetal death, stillbirth, and death immediately after delivery was 0.1, 0.4 and 0.6%, respectively. By multivariable logistic regression analysis, congenital anomalies, low Apgar scores, multi-pregnancy and amniotic fluid contamination were risk factors of adverse perinatal outcomes. Despite a higher rate of pregnancy complications than in 2010 survey, perinatal and neonatal mortality continued to fall, in particular in very preterm births. The high cesarean delivery rate in non-medically indicated cases remained a challenge.ConclusionsOur regional birth-population data in 2015 revealed a robust and persistent improvement in the perinatal care and management of high risk pregnancies and deliveries, which should enable more studies using similar concept and protocol for vital statistics to verify the reliability and feasibility.
Highlights
The objective of this survey was to explore the association between pregnancy complications and perinatal outcome from regionally total birth population
The relationship between pregnancy, or perinatally-associated, co-morbidities and complications and the outcome of hospitalized neonates remain to be clarified in sub-provincial regions
Given the incompleteness and inaccuracy of current official vital statistics on all births not including those neonates with a gestational age < 28 weeks [6, 14], our concept and methodology of regional birth-population based registry may provide a valuable tool for assessing quality of maternal-fetal care and perinatal and neonatal outcomes
Summary
Study region and population The survey was conducted in Huai’an city, with a population of 5,400,000-5,600,000 and around 60,000 annual births in 2009–2014 [16]. Study design: prospective, cross-sectional survey of complete birth data from hospital deliveries with information on pregnancy complications and perinatal morbidities and mortalities. Study population: all births (from gestational age of 22 complete weeks) [18, 19] including fetal death, stillbirth and live births collected consecutively from Jan 1 to Dec 31, 2015. Study variables: maternal characteristics included age, education years and socioeconomic status, as well as pregnancy complications, and perinatal and neonatal morbidity and mortality. Definitions of vital statistics and perinatal morbidities Live birth, fetal death, stillbirth, or death during delivery are defined according to the 10th revision of the international classification of diseases [18]. Perinatal mortality includes all fetal deaths/stillbirth from 22 complete gestational week and neonatal deaths in the first 7 postnatal days in reference to total births. Values were presented as odds ratio (OR) with 95% confidence interval (CI)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
