{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:10:12Z","timestamp":1765728612895},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,2,20]],"date-time":"2017-02-20T00:00:00Z","timestamp":1487548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/igo\/legalcode"}],"funder":[{"DOI":"10.13039\/100006660","name":"United Nations Fund for Population Activities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006660","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the extent to which stillbirths affect international comparisons of preterm birth rates in low\u2010 and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of a multi\u2010country cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>29 countries participating in the World Health Organization Multicountry Survey on Maternal and Newborn Health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>258 215 singleton deliveries in 286 hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe how inclusion or exclusion of stillbirth affect rates of preterm births in 29 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Preterm delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all countries, preterm birth rates were substantially lower when based on live births only, than when based on total births. However, the increase in preterm birth rates with inclusion of stillbirths was substantially higher in low Human Development Index (<jats:styled-content style=\"fixed-case\">HDI<\/jats:styled-content>) countries [median 18.2%, interquartile range (17.2\u201334.6%)] compared with medium (4.3%, 3.0\u20136.7%), and high\u2010<jats:styled-content style=\"fixed-case\">HDI<\/jats:styled-content> countries (4.8%, 4.4\u20135.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Inclusion of stillbirths leads to higher estimates of preterm birth rate in all countries, with a disproportionately large effect in low\u2010<jats:styled-content style=\"fixed-case\">HDI<\/jats:styled-content> countries. Preterm birth rates based on live births alone do not accurately reflect international disparities in perinatal health; thus improved registration and reporting of stillbirths are necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Inclusion of stillbirths increases preterm birth rates estimates, especially in low\u2010<jats:styled-content style=\"fixed-case\">HDI<\/jats:styled-content> countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14548","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T16:07:28Z","timestamp":1487693248000},"page":"1346-1354","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of stillbirths on international comparisons of preterm birth rates: a secondary analysis of the <scp>WHO<\/scp> multi\u2010country survey of Maternal and Newborn Health"],"prefix":"10.1111","volume":"124","author":[{"given":"N","family":"Morisaki","sequence":"first","affiliation":[{"name":"Department of Social Medicine National Center for Child Health and Research Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Ganchimeg","sequence":"additional","affiliation":[{"name":"Department of Global Health Nursing Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JP","family":"Vogel","sequence":"additional","affiliation":[{"name":"UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) Department of Reproductive Health and Research World Health Organization Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"Perinatal and Pediatric Epidemiology Research Team Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9, DHU Risks in Pregnancy Paris Descartes University Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JG","family":"Cecatti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology School of Medical Sciences University of Campinas Campinas Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JP","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Social Medicine Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Pileggi Castro","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MR","family":"Torloni","sequence":"additional","affiliation":[{"name":"Evidence Based Healthcare Post\u2010graduate Program Sao Paulo Federal University Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Ota","sequence":"additional","affiliation":[{"name":"Global Health Nursing Graduate School of Nursing Science St. Luke's International University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Health Policy National Center for Child Health and Development Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SM","family":"Dolan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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