Liveborn and stillborn very low birthweight infants in Switzerland: comparison between hospital based birth registers and the national birth register.
OBJECTIVE
Perinatal and infant mortality rates are considered key indicators of medical care. The aim of this investigation was to examine how representative and reliable the official national figures of Switzerland are by comparing them with the data in local birth registers.


METHODS
124 of 156 maternity hospitals in Switzerland, catering for about 80% of all newborn infants, participated in the study. The hospital based birth registers were screened for the years 1996 and 2000 for live and stillborn infants weighing less than 1500 g. These data were matched with the data in the official register (federal office for statistics).


RESULTS
in 1996 a total of 753 newborn infants and in 2000 820 infants weighing between 300 and 1499 g were officially registered. In the hospital based registers in 1996 101 additional infants and in 2000 94 infants were identified that had not been officially registered; 31 of these were stillborn before 24 completed weeks. Infants registered only locally had lower birth weight and lower gestational age than those recorded in both registers.


CONCLUSIONS
In Switzerland a significant number of very low birth weight infants who died soon after birth are not officially registered. If these infants are included, the national perinatal mortality rate would increase from 6.9 per thousand to 8.0 per thousand. Reasons for underreporting are unclear but may be due to varying definitions of stillbirth and different lower limits for reporting in various cantons. We suggest adopting the WHO-rules for reporting all births and to include gestational age, head circumference, Apgar scores and umbilical artery pH in the national birth register.
Müller
Martina
M
Klinik für Neonatologie, UniversitätsSpital Zürich, Switzerland.
Drack
Gero
G
Schindler
Christian
C
Bucher
Hans Ulrich
HU
D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D036801:Parturition; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries / Q000706:statistics & numerical data*; D013557:Switzerland