The influence of prenatal screening and termination of pregnancy on perinatal mortality rates.
OBJECTIVE
This study concerns the possible effect of practice of prenatal screening of congenital anomalies followed by termination of pregnancy on the perinatal mortality between European countries.


METHODS
Data of nine region-specific EUROCAT registries from five European countries were used to compare the pregnancy termination rate and perinatal mortality due to congenital anomalies between the registries. The impact of pregnancy terminations on the perinatal mortality rate was estimated using a calculated lethality for each congenital anomaly in the hypothetical case that no pregnancy terminations had been performed and was expressed in the 'natural' perinatal mortality rate.


RESULTS
There are large differences between the EUROCAT registries in the number of pregnancy terminations for congenital anomalies. The difference between the 'natural' and regular perinatal mortality rate vary between 3.7 and 14.1 per 10 000 live births and stillbirths. The difference is greater in regions where prenatal screening is more common than in regions where this is not common.


CONCLUSIONS
Differences in practice of prenatal screening and termination of pregnancy of congenital anomalies contribute to the variations in the overall perinatal mortality rate between European regions and countries.
van der Pal-de Bruin
K M
KM
TNO Prevention and Health, PO BOX 2215, 2301 CE Leiden, The Netherlands. KM.vanderPal@pg.tno.nl
Graafmans
W
W
Biermans
M C J
MC
Richardus
J H
JH
Zijlstra
A G
AG
Reefhuis
J
J
Mackenbach
J P
JP
Verloove-Vanhorick
S P
SP
D000025:Abortion, Eugenic / Q000706:statistics & numerical data* / Q000639:trends; D000328:Adult; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate