Perinatal health monitoring through a European lens: eight lessons from the Euro-Peristat report on 2015 births

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Variations in multiple birth rates and impact on perinatal outcomes in Europe

Objective: Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods: We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with randomeffects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results: In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (<37 weeks GA), an almost 12-fold increased risk (pRR 11.7, 95% CI 11.0-12.4) of very preterm birth (<32 weeks GA). Pooled RR were 2.4 (95% Cl1.5-3.6) for fetal mortality at or after 28 weeks GA and 7.0 (95% Cl 6.1-8.0) for neonatal mortality. PAR of neonatal death and very preterm birth were higher in countries with high MBR compared to low MBR (17.1% (95% CI 13.8-20.2) versus 9.8% (95% Cl 9.6-11.0) for neonatal death and 29.6% (96% CI 28.5-30.6) versus 17.5% (95% CI 15.7-18.3) for very preterm births, respectively). Conclusions: Wide variations in MBR and their impact on population outcomes imply that efforts by countries to reduce MBR could improve perinatal outcomes, enabling better long-term child health

Population birth data and pandemic readiness in Europe

The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to respond to an infectious disease outbreak. It is essential to learn from these deficiencies to prepare for future epidemics. One major gap is the limited availability of timely and comprehensive population-based routine data about COVID-19's impact on pregnant women and babies. As part of the Horizon 2020 PHIRI (Population Health Information Research Infrastructure) project on the use of population data for COVID-19 surveillance, the Euro-Peristat research network investigated the extent to which routine information systems could be used to assess the effects of the pandemic by constructing indicators of maternal and child health and of COVID-19 infection. The Euro-Peristat network brings together researchers and statisticians from 31 countries to monitor population indicators of perinatal health in Europe and periodically compiles data on a set of 10 core and 20 recommended indicators1