{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T22:05:18Z","timestamp":1769637918466,"version":"3.49.0"},"reference-count":28,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Stillbirth and in-hospital mortality rates associated with very preterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what proportion of the variation in stillbirth and in-hospital VPT mortality rates persists after adjusting for population demographics, case-mix, and timing of death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Standardized data collection for a geographically defined prospective cohort of VPTs (22+0\u201331+6 weeks gestation) across 16 regions in Europe. Crude and adjusted stillbirth and in-hospital mortality rates for VPT infants were calculated by time of death by using multinomial logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The stillbirth and in-hospital mortality rate for VPTs was 27.7% (range, 19.9%\u201335.9% by region). Adjusting for maternal and pregnancy characteristics had little impact on the variation. The addition of infant characteristics reduced the variation of mortality rates by approximately one-fifth (4.8% to 3.9%). The SD for deaths &amp;lt;12 hours after birth was reduced by one-quarter, but did not change after risk adjustment for deaths \u226512 hours after birth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>In terms of the regional variation in overall VPT mortality, over four-fifths of the variation could not be accounted for by maternal, pregnancy, and infant characteristics. Investigation of the timing of death showed that these characteristics only accounted for a small proportion of the variation in VPT deaths. These findings suggest that there may be an inequity in the quality of care provision and treatment of VPT infants across Europe.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2016-1990","type":"journal-article","created":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T09:10:15Z","timestamp":1490346615000},"source":"Crossref","is-referenced-by-count":47,"title":["Variability in Very Preterm Stillbirth and In-Hospital Mortality Across Europe"],"prefix":"10.1542","volume":"139","author":[{"given":"Elizabeth S.","family":"Draper","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Leicester, Leicester, United Kingdom;"}]},{"given":"Bradley N.","family":"Manktelow","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Leicester, Leicester, United Kingdom;"}]},{"given":"Marina","family":"Cuttini","sequence":"additional","affiliation":[{"name":"Clinical Care and Management Innovation Research Area, Bambino Ges\u00f9 Children\u2019s Hospital, Rome, Italy;"}]},{"given":"Rolf F.","family":"Maier","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, University Hospital, Philipps University Marburg, Marburg, Germany;"}]},{"given":"Alan C.","family":"Fenton","sequence":"additional","affiliation":[{"name":"Newcastle Neonatal Services, Royal Victoria Infirmary, Newcastle, United Kingdom;"}]},{"given":"Patrick","family":"Van Reempts","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium;"},{"name":"Flemish Study Centre for Perinatal Epidemiology, Brussels, Belgium;"}]},{"given":"Anna-Karin","family":"Bonamy","sequence":"additional","affiliation":[{"name":"Departments of Medicine Solna and"},{"name":"Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden;"}]},{"given":"Jan","family":"Mazela","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland;"}]},{"given":"Klaus","family":"B\u1d13rch","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Hvidovre University Hospital, Hvidovre, Denmark;"}]},{"given":"Corinne","family":"Koopman-Esseboom","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children\u2019s Hospital, University Medical Centre Utrecht, Utrecht, Netherlands;"}]},{"given":"Heili","family":"Varendi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Tartu, Tartu University Hospital, Tartu, Estonia;"}]},{"given":"Henrique","family":"Barros","sequence":"additional","affiliation":[{"name":"EPIUnit Institute of Public Health, University of Porto, Porto, Portugal; and"}]},{"given":"Jennifer J.","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"INSERM, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and 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