Regional and practitioner variations in reporting infant mortality

Clarissa Polen-De; Beena D. Kamath-Rayne; Neera Goyal; Emily DeFranco

doi:10.1080/14767058.2020.1749589

Regional and practitioner variations in reporting infant mortality

Clarissa Polen-De, Beena D. Kamath-Rayne, Neera Goyal, Emily DeFranco

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: Assess regional differences in categorization of preterm delivery outcomes and impact on variation in reported infant mortality rates. Study design: A 27-item questionnaire was distributed to 1072 practitioners associated with U.S. birth hospitals. Five clinical scenarios were created to identify how participants classify delivery outcomes. Statistical analysis included Chi-square analysis and multinomial logistic regression. Results: 234 questionnaires were completed (response rate 22%). While >90% respondents classified a 14-week pregnancy loss with no sign of life as a miscarriage, only 22% would provide a fetal death certificate. Likewise, 37% would provide a certificate of live birth for a loss at 16 weeks with signs of life. There was notable regional variation in classifying these as live births (Northeast: 41%, Midwest: 44%, South: 13%, and West: 18%, p =.003). Conclusion: Regional practice variation in recording both live births and stillbirths was noted. Greater standardization in reporting practices may be warranted to improve the accuracy of reported birth outcomes in the U.S.

Original language	English
Pages (from-to)	1278-1285
Number of pages	8
Journal	Journal of Maternal-Fetal and Neonatal Medicine
Volume	35
Issue number	7
DOIs	https://doi.org/10.1080/14767058.2020.1749589
State	Published - 2022

Bibliographical note

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.

Funding

This study was supported by NIH/CTSA CCTST Grant Number [5UL1TR001425-04]. The contents of the study are the responsibility of the authors and do not necessarily represent official NIH views. Dr. DeFranco received research funding from the Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; and March of Dimes Prematurity Research Center Ohio Collaborative. The research team would like to thank the individuals who generously shared their time, experience, and opinions for the purposes of this study.

Funders	Funder number
Perinatal Institute
National Institutes of Health (NIH)
Cincinnati Children's Hospital Medical Center
March of Dimes Prematurity Research Center Ohio Collaborative
Georgia Clinical and Translational Science Alliance	5UL1TR001425-04

Keywords

infant mortality
practitioner variation
Preterm birth
regional variation

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/14767058.2020.1749589

Cite this

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title = "Regional and practitioner variations in reporting infant mortality",

abstract = "Objective: Assess regional differences in categorization of preterm delivery outcomes and impact on variation in reported infant mortality rates. Study design: A 27-item questionnaire was distributed to 1072 practitioners associated with U.S. birth hospitals. Five clinical scenarios were created to identify how participants classify delivery outcomes. Statistical analysis included Chi-square analysis and multinomial logistic regression. Results: 234 questionnaires were completed (response rate 22%). While >90% respondents classified a 14-week pregnancy loss with no sign of life as a miscarriage, only 22% would provide a fetal death certificate. Likewise, 37% would provide a certificate of live birth for a loss at 16 weeks with signs of life. There was notable regional variation in classifying these as live births (Northeast: 41%, Midwest: 44%, South: 13%, and West: 18%, p =.003). Conclusion: Regional practice variation in recording both live births and stillbirths was noted. Greater standardization in reporting practices may be warranted to improve the accuracy of reported birth outcomes in the U.S.",

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N2 - Objective: Assess regional differences in categorization of preterm delivery outcomes and impact on variation in reported infant mortality rates. Study design: A 27-item questionnaire was distributed to 1072 practitioners associated with U.S. birth hospitals. Five clinical scenarios were created to identify how participants classify delivery outcomes. Statistical analysis included Chi-square analysis and multinomial logistic regression. Results: 234 questionnaires were completed (response rate 22%). While >90% respondents classified a 14-week pregnancy loss with no sign of life as a miscarriage, only 22% would provide a fetal death certificate. Likewise, 37% would provide a certificate of live birth for a loss at 16 weeks with signs of life. There was notable regional variation in classifying these as live births (Northeast: 41%, Midwest: 44%, South: 13%, and West: 18%, p =.003). Conclusion: Regional practice variation in recording both live births and stillbirths was noted. Greater standardization in reporting practices may be warranted to improve the accuracy of reported birth outcomes in the U.S.

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Regional and practitioner variations in reporting infant mortality

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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