{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:14:14Z","timestamp":1791936854720,"version":"4.3.4"},"reference-count":18,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To explore the differences in outcome of very preterm pregnancies between two geographically defined populations in Europe with similar socioeconomic characteristics and healthcare provision but different organisational arrangements for perinatal care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Nord Pas-de-Calais (NPC), France, and Trent, UK.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants:<\/jats:title>\n                  <jats:p>All pregnancy outcomes 22<jats:sup>+0<\/jats:sup> to 32<jats:sup>+6<\/jats:sup> weeks\u2019 gestational age for resident mothers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures:<\/jats:title>\n                  <jats:p>Mortality patterns (antepartum death, intrapartum death, labour ward death and neonatal unit death) among very preterm babies were analysed by region. Multinomial logistic regression was used to model regional differences for a variety of pregnancy outcomes and to adjust for regional differences in the organisation of perinatal care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Delivery of very preterm infants was significantly higher in Trent compared with NPC (1.9% <jats:italic>v<\/jats:italic> 1.5% of all births, respectively (p&lt;0.001)). Stillbirth rate was significantly higher in NPC than in Trent (23.0%, 95% CI 20.0% to 26.5% <jats:italic>v<\/jats:italic> 14.4%, 95% CI 12.3% to 16.6%, respectively (p&lt;0.001)) and survival to discharge was higher in Trent than in NPC (74.6%, 95% CI 71.9% to 77.1% <jats:italic>v<\/jats:italic> 66.7%, 95% CI 63.3% to 69.9%, respectively (p&lt;0.001)). Probability of intrapartum and labour ward death in NPC was more than five times higher than Trent (relative risk 5.3, 95% CI 2.2 to 13.1 (p&lt;0.001)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>The high rate of very preterm deliveries and the larger proportion of these infants recorded as live born in Trent appear to be the cause of the excess neonatal mortality seen in the routine statistics. Information about very preterm babies (not usually included in routine statistics) is vital to avoid inappropriate interpretation of international perinatal and infant data. This study highlights the importance of including deaths before transfer to neonatal care and emphasises the need to include the outcome of all pregnancies in a population in any comparative analysis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/adc.2006.097683","type":"journal-article","created":{"date-parts":[[2007,1,9]],"date-time":"2007-01-09T23:37:29Z","timestamp":1168385849000},"page":"356-360","source":"Crossref","is-referenced-by-count":24,"title":["Mortality patterns among very preterm babies: a comparative analysis of two European regions in France and England"],"prefix":"10.1136","volume":"92","author":[{"given":"Elizabeth S","family":"Draper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Zeitlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Field","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley N","family":"Manktelow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Truffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2007,1,9]]},"reference":[{"key":"2025090222045594000_92.5.356.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2001.00356.x"},{"key":"2025090222045594000_92.5.356.2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1046\/j.1365-3016.2002.00390.x","article-title":"Registration artifacts in international comparisons of infant mortality.","volume":"16","author":"Kramer","year":"2002","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2025090222045594000_92.5.356.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.02053.x"},{"key":"2025090222045594000_92.5.356.4","doi-asserted-by":"crossref","first-page":"F172","DOI":"10.1136\/fn.87.3.F172","article-title":"Extreme prematurity in the UK and Denmark: population differences in viability.","volume":"87","author":"Field","year":"2002","journal-title":"Arch Dis Child"},{"key":"2025090222045594000_92.5.356.5","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1002\/sim.4780071202","article-title":"Inborn\/outborn status and neonatal survival: a meta-analysis of non randomised studies.","volume":"7","author":"Ozminkowski","year":"1988","journal-title":"Stat Med"},{"key":"2025090222045594000_92.5.356.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540130052029"},{"key":"2025090222045594000_92.5.356.7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/j.1440-1754.1994.tb00685.x","article-title":"Outcome of neonates transported between level III centres depends upon centre of care.","volume":"30","author":"Harding","year":"1994","journal-title":"J Paediatr Child Health"},{"key":"2025090222045594000_92.5.356.8","doi-asserted-by":"publisher","DOI":"10.1136\/fn.80.2.F111"},{"key":"2025090222045594000_92.5.356.9","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/S0095-5108(18)30227-6","article-title":"Can and should level II nurseries care for newborns who require mechanical ventilation.","volume":"23","author":"Meadow","year":"1996","journal-title":"Clin Perinatol"},{"key":"2025090222045594000_92.5.356.10","doi-asserted-by":"publisher","DOI":"10.1002\/pd.442"},{"key":"2025090222045594000_92.5.356.11","doi-asserted-by":"publisher","DOI":"10.1159\/000053901"},{"key":"2025090222045594000_92.5.356.12","first-page":"139","article-title":"Survival of very preterm infants. Epipage: a population based cohort,","volume-title":"Arch Dis Child","volume":"89","author":"Larroque","year":"2004"},{"key":"2025090222045594000_92.5.356.13","unstructured":"Field DJ Draper ES . Trent neonatal survey report 1997, Trent Infant Mortality and Morbidity Studies. Trent Institute for Health Services Research, 1998"},{"key":"2025090222045594000_92.5.356.14","unstructured":"Clarke M Draper E James D . Confidential enquiry into stillbirths and deaths in infancy (CESDI) 1997, Trent Infant Mortality and Morbidity Studies. Trent Institute for Health Services Research, 1998"},{"key":"2025090222045594000_92.5.356.15","unstructured":"Maternal and Child Health Research Consortium. 8th annual report. Confidential enquiry into stillbirths and deaths in infancy. Chapter 2: Infant and Perinatal Mortality 1999, London:Maternal and Child Health Research Consortium, 2001"},{"key":"2025090222045594000_92.5.356.16","unstructured":"World Health Organization Regional Office for Europe. European health for all database (HFA-DB). http:\/\/www.euro.who.int\/hfadb (accessed January 2005)"},{"key":"2025090222045594000_92.5.356.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02378-3"},{"key":"2025090222045594000_92.5.356.18","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.02323.x"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/adc.2006.097683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T05:05:10Z","timestamp":1756875910000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/adc.2006.097683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1,9]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2007,8,21]]},"published-print":{"date-parts":[[2007,9]]}},"alternative-id":["10.1136\/adc.2006.097683"],"URL":"https:\/\/doi.org\/10.1136\/adc.2006.097683","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1,9]]}}}