Influence of prenatal diagnosis and pregnancy termination of fetuses with birth defects on the perinatal mortality rate in Victoria, Australia

Summary Historical data show that in Victoria birth defects have accounted for approximately 25% of all perinatal deaths. Terminations of pregnancies (TOPs) for birth defects occurring at ≥20 weeks gestation are included in the population‐based perinatal data collection. These are classified as stil...

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Published in:Paediatric and perinatal epidemiology 2005-01, Vol.19 (1), p.50-55
Main Authors: Davidson, Natasha, Halliday, Jane, Riley, Merilyn, King, James
Format: Article
Language:English
Subjects:
Abortion, Induced - mortality
Abortion, Induced - trends
Congenital Abnormalities - mortality
Female
Fetus - abnormalities
Gestational Age
Humans
Infant Mortality - trends
Infant, Newborn
Poisson Distribution
Pregnancy
Prenatal Diagnosis - mortality
Victoria - epidemiology
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cited_by cdi_FETCH-LOGICAL-c4040-1b42c857b829155f60cb0c5943774ae529b9c5615a288538821b2f160abeef903
cites cdi_FETCH-LOGICAL-c4040-1b42c857b829155f60cb0c5943774ae529b9c5615a288538821b2f160abeef903
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container_title Paediatric and perinatal epidemiology
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creator Davidson, Natasha
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Riley, Merilyn
King, James
description Summary Historical data show that in Victoria birth defects have accounted for approximately 25% of all perinatal deaths. Terminations of pregnancies (TOPs) for birth defects occurring at ≥20 weeks gestation are included in the population‐based perinatal data collection. These are classified as stillbirths or neonatal deaths. Some would have survived the perinatal period if no termination had taken place, and as a result they have the effect of increasing the perinatal mortality rate (PMR). Conversely, TOPs 50% likelihood of death, ‘possibly lethal’ 15–50% and ‘non‐lethal’ less than 15%. Based on these ‘lethality’ groups and associated assumptions about average survival rates beyond the neonatal period, the PMR was recalculated. TOPs for ‘non‐lethal’ birth defects at ≥20 weeks gestation increased the PMR by 3.8%. TOPs for ‘lethal’ birth defects
doi_str_mv 10.1111/j.1365-3016.2004.00620.x
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Terminations of pregnancies (TOPs) for birth defects occurring at ≥20 weeks gestation are included in the population‐based perinatal data collection. These are classified as stillbirths or neonatal deaths. Some would have survived the perinatal period if no termination had taken place, and as a result they have the effect of increasing the perinatal mortality rate (PMR). Conversely, TOPs &lt;20 weeks gestation, of fetuses with lethal birth defects that would have resulted in a perinatal death, are not included in the statistics and therefore reduce the PMR. The aim of this study was to examine the effect on the PMR of TOPs following the prenatal detection of birth defects, taking into account the severity or ‘lethality’ of the birth defects. Data on live births, stillbirths, neonatal deaths and TOPs carried out because of a birth defect were collected from the Victorian Birth Defects Register (BDR) for 1989–2000. Birth defects were categorised into three groups, according to the estimated likelihood of a baby with that condition dying in the perinatal period: a ‘lethal’ birth defect was one where there was &gt;50% likelihood of death, ‘possibly lethal’ 15–50% and ‘non‐lethal’ less than 15%. Based on these ‘lethality’ groups and associated assumptions about average survival rates beyond the neonatal period, the PMR was recalculated. TOPs for ‘non‐lethal’ birth defects at ≥20 weeks gestation increased the PMR by 3.8%. TOPs for ‘lethal’ birth defects &lt;20 weeks decreased the PMR by 14.4%. 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Terminations of pregnancies (TOPs) for birth defects occurring at ≥20 weeks gestation are included in the population‐based perinatal data collection. These are classified as stillbirths or neonatal deaths. Some would have survived the perinatal period if no termination had taken place, and as a result they have the effect of increasing the perinatal mortality rate (PMR). Conversely, TOPs &lt;20 weeks gestation, of fetuses with lethal birth defects that would have resulted in a perinatal death, are not included in the statistics and therefore reduce the PMR. The aim of this study was to examine the effect on the PMR of TOPs following the prenatal detection of birth defects, taking into account the severity or ‘lethality’ of the birth defects. Data on live births, stillbirths, neonatal deaths and TOPs carried out because of a birth defect were collected from the Victorian Birth Defects Register (BDR) for 1989–2000. 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Terminations of pregnancies (TOPs) for birth defects occurring at ≥20 weeks gestation are included in the population‐based perinatal data collection. These are classified as stillbirths or neonatal deaths. Some would have survived the perinatal period if no termination had taken place, and as a result they have the effect of increasing the perinatal mortality rate (PMR). Conversely, TOPs &lt;20 weeks gestation, of fetuses with lethal birth defects that would have resulted in a perinatal death, are not included in the statistics and therefore reduce the PMR. The aim of this study was to examine the effect on the PMR of TOPs following the prenatal detection of birth defects, taking into account the severity or ‘lethality’ of the birth defects. Data on live births, stillbirths, neonatal deaths and TOPs carried out because of a birth defect were collected from the Victorian Birth Defects Register (BDR) for 1989–2000. Birth defects were categorised into three groups, according to the estimated likelihood of a baby with that condition dying in the perinatal period: a ‘lethal’ birth defect was one where there was &gt;50% likelihood of death, ‘possibly lethal’ 15–50% and ‘non‐lethal’ less than 15%. Based on these ‘lethality’ groups and associated assumptions about average survival rates beyond the neonatal period, the PMR was recalculated. TOPs for ‘non‐lethal’ birth defects at ≥20 weeks gestation increased the PMR by 3.8%. TOPs for ‘lethal’ birth defects &lt;20 weeks decreased the PMR by 14.4%. The net effect on the overall PMR from TOPs for birth defects was a 10.6% decrease.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>15670109</pmid><doi>10.1111/j.1365-3016.2004.00620.x</doi><tpages>6</tpages></addata></record>
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subjects Abortion, Induced - mortality
Abortion, Induced - trends
Congenital Abnormalities - mortality
Female
Fetus - abnormalities
Gestational Age
Humans
Infant Mortality - trends
Infant, Newborn
Poisson Distribution
Pregnancy
Prenatal Diagnosis - mortality
Victoria - epidemiology
title Influence of prenatal diagnosis and pregnancy termination of fetuses with birth defects on the perinatal mortality rate in Victoria, Australia
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