Differences in perinatal and infant mortality in high-income countries ...

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System (Public Health Agency of Canada) ... were lower in Canada and United States compared with Finland. ... systems and for changing health policy.
Deb-Rinker et al. BMC Pediatrics (2015) 15:112 DOI 10.1186/s12887-015-0430-8

RESEARCH ARTICLE

Open Access

Differences in perinatal and infant mortality in high-income countries: artifacts of birth registration or evidence of true differences? Paromita Deb-Rinker1*, Juan Andrés León1, Nicolas L. Gilbert1, Jocelyn Rouleau1, Anne-Marie Nybo Andersen2, Ragnheiður I. Bjarnadóttir3, Mika Gissler4, Laust H. Mortensen2, Rolv Skjærven5, Stein Emil Vollset5, Xun Zhang6, Prakesh S. Shah7, Reg S. Sauve8, Michael S. Kramer6, K. S. Joseph9 and for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)

Abstract Background: Variation in birth registration criteria may compromise international comparisons of fetal and infant mortality. We examined the effect of birth registration practices on fetal and infant mortality rates to determine whether observed differences in perinatal and infant mortality rates were artifacts of birth registration or reflected true differences in health status. Methods: A retrospective population-based cohort study was done using data from Canada, United States, Denmark, Finland, Iceland, Norway, and Sweden from 1995–2005. Main outcome measures included live births by gestational age and birth weight; gestational age—and birth weight-specific stillbirth rates; neonatal, post-neonatal, and cause-specific infant mortality. Results: Proportion of live births