Lancet. 1990 Sep 29;336(8718):782-4.
International comparison of perinatal mortality rates is subject to various problems in methods of reporting. The main difficulties are differences in the definition of livebirth and the variation in policies on the elective delivery of very preterm fetuses at risk of intrauterine death. This study, based on geographically defined populations within the European Community, set out to compare survival rates in very low birthweight infants (below 1500 g). The first phase of the study in seven populations showed pronounced differences in survival and in the proportion of liveborn infants who weighed less than 1000 g. A further phase studied the outcome of all pregnancies from 22 to 28 weeks' gestation in four populations. There was no significant difference between the four populations in crude survival rates per 1000 livebirths among infants born at 22 to 28 weeks' gestation, but more babies were born alive at the earlier gestations in the United Kingdom. Survival rates were higher in Scotland and England when gestational age at birth was controlled for. Future comparisons of the outcome of perinatal care for extremely immature infants would be more meaningful if data on the outcome of all pregnancies ending after 22 weeks' gestation were routinely collected through the registration system.
围产期死亡率的国际比较在报告方法上存在各种问题。主要困难在于活产定义的差异以及对有宫内死亡风险的极早产儿进行选择性分娩的政策差异。这项基于欧洲共同体地理界定人群的研究，旨在比较极低出生体重婴儿（低于1500克）的存活率。该研究在七个群体中的第一阶段显示，存活率以及体重低于1000克的活产婴儿比例存在显著差异。进一步的阶段研究了四个群体中所有妊娠22至28周的结局。在妊娠22至28周出生的婴儿中，每1000例活产的粗存活率在这四个群体之间没有显著差异，但在英国，更早孕周出生的存活婴儿更多。在控制出生孕周后，苏格兰和英格兰的存活率更高。如果通过登记系统常规收集所有妊娠22周后结束的结局数据，那么未来对极不成熟婴儿围产期护理结局的比较将更有意义。
