How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy?

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  • Additional Information
    • Author-Supplied Keywords:
      Birth weight
      Infant mortality
      International comparison
      Neonatal mortality
      Post-neonatal mortality
      Stillbirth
    • Abstract:
      Background: Infant mortality rates are commonly used to compare the health of populations. Observed differences are often attributed to variation in child health care quality. However, any differences are at least partly explained by variation in the prevalence of risk factors at birth, such as low birth weight. This distinction is important for designing interventions to reduce infant mortality. We suggest a simple method for decomposing inter-country differences in crude infant mortality rates into two metrics representing risk factors operating before and after birth.Methods: We used data from 7 European countries participating in the EURO-PERISTAT project in 2010. We calculated crude and birth weight-standardised stillbirth and infant mortality rates using Norway as the standard population. We decomposed between-country differences in crude stillbirth and infant mortality rates into the within-country difference in crude and birth weight-standardised stillbirth and infant mortality rates (metric 1), reflecting prenatal risk factors, and the between-country difference in birth weight-standardised stillbirth and infant mortality rates (metric 2), reflecting risk factors operating after birth. We also calculated birth weight-specific mortality.Results: Using our metrics, we showed that for England, Wales and Scotland risk factors before and after birth contributed equally to the differences in crude stillbirth and infant mortality rates relative to Norway. In Austria, Czech Republic and Switzerland the differences were driven primarily by metric 1, reflecting high rate of low birth weight. The highest values of metric 2 observed in Poland partially reflected high rates of congenital anomalies.Conclusions: Our suggested metrics can be used to guide policy decisions on preventing infant deaths through reducing risk factors at birth or improving the care of babies after birth. Aggregate data tabulated by birth weight/gestational age should be routinely collected and published in high-income countries where birth weight is reported on birth certificates. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1The Farr Institute of Health Informatics Research, 222 Euston Road, London NW1 2DA, UK
      2UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
      3Centre for Health Equity Studies (CHESS), Stockholm University, SE-10691 Stockholm, Sweden
      4Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, 171 76 Solna, Stockholm, Sweden
    • ISSN:
      1471-2393
    • Accession Number:
      10.1186/s12884-017-1622-z
    • Accession Number:
      126987726
  • Citations
    • ABNT:
      ZYLBERSZTEJN, A. et al. How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy & Childbirth, [s. l.], v. 17, p. 1–7, 2017. DOI 10.1186/s12884-017-1622-z. Disponível em: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=126987726&authtype=sso&custid=s5834912. Acesso em: 26 jan. 2020.
    • AMA:
      Zylbersztejn A, Gilbert R, Hjern A, Hardelid P. How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy & Childbirth. 2017;17:1-7. doi:10.1186/s12884-017-1622-z.
    • APA:
      Zylbersztejn, A., Gilbert, R., Hjern, A., & Hardelid, P. (2017). How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy & Childbirth, 17, 1–7. https://doi.org/10.1186/s12884-017-1622-z
    • Chicago/Turabian: Author-Date:
      Zylbersztejn, Ania, Ruth Gilbert, Anders Hjern, and Pia Hardelid. 2017. “How Can We Make International Comparisons of Infant Mortality in High Income Countries Based on Aggregate Data More Relevant to Policy?” BMC Pregnancy & Childbirth 17 (December): 1–7. doi:10.1186/s12884-017-1622-z.
    • Harvard:
      Zylbersztejn, A. et al. (2017) ‘How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy?’, BMC Pregnancy & Childbirth, 17, pp. 1–7. doi: 10.1186/s12884-017-1622-z.
    • Harvard: Australian:
      Zylbersztejn, A, Gilbert, R, Hjern, A & Hardelid, P 2017, ‘How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy?’, BMC Pregnancy & Childbirth, vol. 17, pp. 1–7, viewed 26 January 2020, .
    • MLA:
      Zylbersztejn, Ania, et al. “How Can We Make International Comparisons of Infant Mortality in High Income Countries Based on Aggregate Data More Relevant to Policy?” BMC Pregnancy & Childbirth, vol. 17, Dec. 2017, pp. 1–7. EBSCOhost, doi:10.1186/s12884-017-1622-z.
    • Chicago/Turabian: Humanities:
      Zylbersztejn, Ania, Ruth Gilbert, Anders Hjern, and Pia Hardelid. “How Can We Make International Comparisons of Infant Mortality in High Income Countries Based on Aggregate Data More Relevant to Policy?” BMC Pregnancy & Childbirth 17 (December 19, 2017): 1–7. doi:10.1186/s12884-017-1622-z.
    • Vancouver/ICMJE:
      Zylbersztejn A, Gilbert R, Hjern A, Hardelid P. How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy & Childbirth [Internet]. 2017 Dec 19 [cited 2020 Jan 26];17:1–7. Available from: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=126987726&authtype=sso&custid=s5834912