论文信息 - Methodological difficulties in the comparison of indicators of perinatal health across Europe.

Methodological difficulties in the comparison of indicators of perinatal health across Europe.

The main purpose of this article is to point out common pitfalls that can confuse comparative analyses of indicators of perinatal health and to discuss ways to overcome or minimize these difficulties. The challenge is to distinguish 'real' variations in the value of an indicator from variations due to differences in registration practices and definitions and from random variation. The first section presents the major properties that are desirable in indicators of perinatal health status and perinatal health care in Europe to be used for comparative purposes. The second section provides specific examples of the types of methodological difficulties encountered in European cross-country comparisons due to variations in the definition, measurement and construction of indicators. The conclusion discusses the PERISTAT project's responses to these difficulties and how these methodological constraints impact on the selection of an appropriate indicator set for Europe today.

[1] G. Borsboom,et al. Birth Weight and Perinatal Mortality: A Comparison of “Optimal” Birth Weight in Seven Western European Countries , 2002, Epidemiology.

[2] G. Breart,et al. Algorithms for combining menstrual and ultrasound estimates of gestational age: consequences for rates of preterm and postterm birth , 2002, BJOG : an international journal of obstetrics and gynaecology.

[3] M. Kramer,et al. How does early ultrasound scan estimation of gestational age lead to higher rates of preterm birth? , 2002, American journal of obstetrics and gynecology.

[4] J. Gardosi. Customized growth curves. , 1997, Clinical obstetrics and gynecology.

[5] J. Mackenbach,et al. Comparability of published perinatal mortality rates in Western Europe: the quantitative impact of differences in gestational age and birthweight criteria , 2001, BJOG : an international journal of obstetrics and gynaecology.

[6] B. Blondel,et al. Changes in risk factors of preterm delivery in France between 1981 and 1995. , 2000, Paediatric and perinatal epidemiology.

[7] A. Wilcox,et al. Bias in studies of preterm and postterm delivery due to ultrasound assessment of gestational age. , 1995 .

[8] D. Savitz,et al. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. , 2002, American journal of obstetrics and gynecology.