Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic: a study of 21 European countries.

Background: Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries.

Stillbirths: Contribution of preterm birth and size-for-gestational age for 125.4 million total births from nationwide records in 13 countries, 2000-2020.

Objective: To examine the contribution of preterm birth and size-for-gestational age in stillbirths using six 'newborn types'.

Design: Population-based multi-country analyses.

Setting: Births collected through routine data systems in 13 countries.

Developing and testing a protocol using a common data model for federated collection and analysis of national perinatal health indicators in Europe.

International comparisons of the health of mothers and babies provide essential benchmarks for guiding health practice and policy, but statistics are not routinely compiled in a comparable way. These data are especially critical during health emergencies, such as the coronavirus disease (COVID-19) pandemic. The Population Health Information Research Infrastructure (PHIRI) project aimed to promote the exchange of population data in Europe and included a Use Case on perinatal health.

Comparing the cognitive functioning of middle-aged and older foreign-origin population in Estonia to host and origin populations.

Background: In migration and health research, the healthy migrant effect has been a common finding, but it usually pertains to specific contexts only. Existing findings are inconsistent and inconclusive regarding the cognitive functioning of the (aging) foreign-origin population relative to the populations of their host and sending countries. Moreover, this comparison is an understudied design setting.

Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000-2020.

Objective: To compare neonatal mortality associated with six novel vulnerable newborn types in 125.5 million live births across 15 countries, 2000-2020.

Design: Population-based, multi-country study.

Vulnerable newborn types: Analysis of population-based registries for 165 million births in 23 countries, 2000-2021.

Objective: To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021.

Design: Population-based, multi-country analysis.

Setting: National data systems in 23 middle- and high-income countries.

International versus national growth charts for identifying small and large-for-gestational age newborns: A population-based study in 15 European countries.

Background: To inform the on-going debate about the use of universal prescriptive versus national intrauterine growth charts, we compared perinatal mortality for small and large-for-gestational-age (SGA/LGA) infants according to international and national charts in Europe.

Methods: We classified singleton births from 33 to 42 weeks of gestation in 2010 and 2014 from 15 countries ( = 1,475,457) as SGA (birthweight <10th percentile) and LGA (>90th percentile) using the international Intergrowth-21st newborn standards and national charts based on the customised charts methodology. We computed sex-adjusted odds ratios (aOR) for stillbirth, neonatal and extended perinatal mortality by this classification using multilevel models.

Variations in very preterm birth rates in 30 high-income countries: are valid international comparisons possible using routine data?

Objective: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons.

Design: Population-based study.

Setting: Twenty-seven European countries, the United States, Canada and Japan in 2010.

Linking databases on perinatal health: a review of the literature and current practices in Europe.

Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought to assess the extent to which data are linked routinely for perinatal health research and reporting.

Varying gestational age patterns in cesarean delivery: an international comparison.

Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and low risk pregnancies based on new scientific evidence. We studied differences and patterns in cesarean delivery rates by multiplicity and gestational age in Europe and the United States.

Non-fatal injuries resulting in activity limitations in Estonia--risk factors and association with the incidence of chronic conditions and quality of life: a retrospective study among the population aged 20-79.

Objectives: Evidence about the health and quality-of-life outcomes of injuries is obtained mainly from follow-up studies of surviving trauma patients; population-based studies are rarer, in particular for countries in Eastern Europe. This study examines the incidence, prevalence and social variation in non-fatal injuries resulting in activity limitations and outcomes of injuries in Estonia.

Design: A retrospective population-based study.

Preterm birth time trends in Europe: a study of 19 countries.

Objective: To investigate time trends in preterm birth in Europe by multiplicity, gestational age, and onset of delivery.

Design: Analysis of aggregate data from routine sources.

Setting: Nineteen European countries.

Reporting of perinatal health indicators for international comparisons--enhancing the appearance of geographical plots.

Background: Tabulating annual national health indicators sorted by outcome may be misleading for two reasons. The implied rank order is largely a result of heterogeneous population sizes. Distinctions between geographically adjacent regions are not visible.

Perinatal health monitoring in Europe: results from the EURO-PERISTAT project.

Data about deliveries, births, mothers and newborn babies are collected extensively to monitor the health and care of mothers and babies during pregnancy, delivery and the post-partum period, but there is no common approach in Europe. We analysed the problems related to using the European data for international comparisons of perinatal health. We made an inventory of relevant data sources in 25 European Union (EU) member states and Norway, and collected perinatal data using a previously defined indicator list.

Self-reported activity limitations among the population aged 20-79 in Estonia: a cross-sectional study.

Background: Along with population ageing, limitations in activities of daily living constitute a rising health-related burden in demographically advanced countries. The present study aims to assess the prevalence of self-reported activity limitations derived from chronic conditions and social variation of limitations in the subgroups of the population aged 20-79 years in Estonia.

Methods: A cross-sectional study employs data from the second round of the Estonian Family and Fertility Survey, a national project in the framework of Gender and Generation Programme.

[Trends in interregional migration in Estonia since 1947].

Migration trends in Estonia since 1947 are reviewed. The analysis indicates that the country's age distribution began to change earlier than that of other Eastern European countries. "Immigration started earlier too, first with the influx from the Estonia hinterland into the capital, then, after the second world war, with the gradual common workforce influx from the Republics of the Soviet Union.