Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data.
Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data.
复制标题
DOI：
10.1186/1471-2393-10-s1-s1
复制
发表时间：
2010-02-23
影响因子：
3.1
通讯作者：
GAPPS Review Group
中科院分区：
文献类型：
--
作者：
Lawn JE;Gravett MG;Nunes TM;Rubens CE;Stanton C;GAPPS Review Group
这是早产和死胎报告中七篇文章中的第一篇。本报告概述了这一负担，评估了目前估计数的质量，审查了趋势，并提出了改进数据的建议。很少有国家拥有可靠的全国早产率数据。在全球范围内，估计每年有1 300万婴儿在妊娠37周之前出生。低收入和中等收入国家的发病率通常最高，在一些中等收入和高收入国家，特别是美洲，发病率还在上升。早产是新生儿死亡的主要直接原因（27%）;每年有100多万早产新生儿死亡。早产也是新生儿死亡的主要危险因素，特别是感染造成的死亡。长期减值是一个日益严重的问题。死产目前没有被纳入千年发展目标跟踪，在全球政策中仍然是不可见的。对于国际比较，死产包括体重超过1000克或妊娠28周后发生的晚期胎儿死亡。所有死产中只有约2%是通过生命登记统计的，全球估计数是基于家庭调查或建模。两项全球估算工作得出了类似的估计，每年约有300万人; 99%发生在低收入和中等收入国家。100万死产发生在分娩期间。全球死产死亡原因估计受到多重复杂分类系统的阻碍。(1)通过家庭调查提高妊娠结果数据的采集和质量，家庭调查是占全球负担75%的国家的主要数据来源;（2）在常规数据收集系统中提高对胎龄和死产标准定义的遵守程度;（3）加强现有的数据收集机制，特别是生命登记和设施数据，建立与修订后的《国际疾病分类》编码挂钩的死产和新生儿死亡标准死亡证明;（4）验证死产死因的简单、标准化分类系统;和（5）改进系统和工具，以捕捉早产后的急性发病率和长期损害结果。缺乏足够的数据妨碍了能见度、有效的政策和研究。改善数据跟踪和减少早产和死产负担的直接机会存在。
This is the first of seven articles from a preterm birth and stillbirth report. Presented here is an overview of the burden, an assessment of the quality of current estimates, review of trends, and recommendations to improve data. Few countries have reliable national preterm birth prevalence data. Globally, an estimated 13 million babies are born before 37 completed weeks of gestation annually. Rates are generally highest in low- and middle-income countries, and increasing in some middle- and high-income countries, particularly the Americas. Preterm birth is the leading direct cause of neonatal death (27%); more than one million preterm newborns die annually. Preterm birth is also the dominant risk factor for neonatal mortality, particularly for deaths due to infections. Long-term impairment is an increasing issue. Stillbirths are currently not included in Millennium Development Goal tracking and remain invisible in global policies. For international comparisons, stillbirths include late fetal deaths weighing more than 1000g or occurring after 28 weeks gestation. Only about 2% of all stillbirths are counted through vital registration and global estimates are based on household surveys or modelling. Two global estimation exercises reached a similar estimate of around three million annually; 99% occur in low- and middle-income countries. One million stillbirths occur during birth. Global stillbirth cause-of-death estimates are impeded by multiple, complex classification systems. (1) increase the capture and quality of pregnancy outcome data through household surveys, the main data source for countries with 75% of the global burden; (2) increase compliance with standard definitions of gestational age and stillbirth in routine data collection systems; (3) strengthen existing data collection mechanisms—especially vital registration and facility data—by instituting a standard death certificate for stillbirth and neonatal death linked to revised International Classification of Diseases coding; (4) validate a simple, standardized classification system for stillbirth cause-of-death; and (5) improve systems and tools to capture acute morbidity and long-term impairment outcomes following preterm birth. Lack of adequate data hampers visibility, effective policies, and research. Immediate opportunities exist to improve data tracking and reduce the burden of preterm birth and stillbirth.