OBJECTIVE: To compare fetal and neonatal mortality in two Italian regions, characterized by different socio-economic factors and health care organisations, and to study the main maternal and fetal determinants of mortality. DESIGN: Cohort study. Distributions of births in 1995-1996 by birthweight and gestational age are described and stillbirth, perinatal and neonatal mortality are analysed and compared. The determinants of mortality (birthweight, gestational age, sociodemographic maternal characteristics and type of delivery) have been analysed using logistic regression models. SETTING: Two Italian regions with the highest number of births, Lombardia and Campania. The first represents the industrialized northern Italy, the second the relatively poorly developed southern Italy. PARTICIPANTS: The analysis concerns 300,697 births, 156,436 of which in Lombardia and 144,261 in Campania. MAIN OUTCOME MEASURES: Stillbirth, perinatal and neonatal mortality rates. RESULTS: The percentage of low birthweight (<2,500 grams) is the same in both regions, that is, 5.2%. The percentage of preterm births is higher in Lombardia than in Campania (5.5% vs 3.9%). Stillbirth, perinatal and neonatal mortality rates are lower in Lombardia than in Campania, that is: 3.6 per thousand and 4.2 per thousand; 5.8 per thousand and 7.6 per thousand; 2.9 per thousand and 4.4 per thousand respectively. CONCLUSION: The comparison between the two regions highlights the different role played by the various main determinants. In particular, the gestational age seems to be more important in Campania than in Lombardia, as it is for the neonatal mortality The analysis provides us with some useful elements strictly related to the delivery characterisitcs and consequently to the kind of health care organisation to explain mortality differences between the two regions.
OBJECTIVE: To compare fetal and neonatal mortality in two Italian regions, characterized by different socio-economic factors and health care organisations, and to study the main maternal and fetal determinants of mortality. DESIGN: Cohort study. Distributions of births in 1995-1996 by birthweight and gestational age are described and stillbirth, perinatal and neonatal mortality are analysed and compared. The determinants of mortality (birthweight, gestational age, sociodemographic maternal characteristics and type of delivery) have been analysed using logistic regression models. SETTING: Two Italian regions with the highest number of births, Lombardia and Campania. The first represents the industrialized northern Italy, the second the relatively poorly developed southern Italy. PARTICIPANTS: The analysis concerns 300,697 births, 156,436 of which in Lombardia and 144,261 in Campania. MAIN OUTCOME MEASURES: Stillbirth, perinatal and neonatal mortality rates. RESULTS: The percentage of low birthweight (<2,500 grams) is the same in both regions, that is, 5.2%. The percentage of preterm births is higher in Lombardia than in Campania (5.5% vs 3.9%). Stillbirth, perinatal and neonatal mortality rates are lower in Lombardia than in Campania, that is: 3.6 per thousand and 4.2 per thousand; 5.8 per thousand and 7.6 per thousand; 2.9 per thousand and 4.4 per thousand respectively. CONCLUSION: The comparison between the two regions highlights the different role played by the various main determinants. In particular, the gestational age seems to be more important in Campania than in Lombardia, as it is for the neonatal mortality The analysis provides us with some useful elements strictly related to the delivery characterisitcs and consequently to the kind of health care organisation to explain mortality differences between the two regions.
Authors: Walter Mazzucco; Rosanna Cusimano; Maurizio Macaluso; Claudio La Scola; Giovanna Fiumanò; Salvatore Scondotto; Achille Cernigliaro; Giovanni Corsello; Giuseppe La Torre; Francesco Vitale Journal: BMC Public Health Date: 2011-10-19 Impact factor: 3.295