INFRAREGISTRATION OF PERINATAL-MORTALITY - 10-YEAR EXPERIENCE OF ACTIVE SURVEILLANCE IN BARCELONA, SPAIN

BACKGROUND: Perinatal mortality is considered a good effectiveness hea lth care indicator during pregnancy, delivery and early perinatal peri od. The aims of this investigation were to describe the magnitude and tendency of underreporting perinatal mortality in Barcelona, Spain fro m 1985 to 1994 and to determine underreporting predictive variables. S UBJECTS AND METHODS: Perinatal deaths between 1985 and 1993 were studi ed according to WHO international statistics criteria and deaths from 1988 to 1993 were also studied according to the WHO national statistic s criteria. Sources of information were: Statistical Deaths Certificat es and the Active Surveillance Registry that collect information about perinatal deaths directly from hospitals. A perinatal death was consi dered as underreported if it was registered in the Active Surveillance Register but not in the Statistical Death Certificate.RESULTS: 24.5% perinatal deaths were underreported from 1985 to 1994 (according to in ternational statistics criteria) and 24.9% from 1988 to 1994 (accordin g national statistics criteria). In both periods underreporting decrea sed. Deaths in the first 24 hours of live (OR = 1.8; Cl 95% = 1-3), ne wborns weight between 1,000 and 1,499 g (OR = 1.5; Cl 95% = 0.6-3.8), hospitals with mortality registry (OR = 4; Cl 95% = 2.2-7.1) and the f irst years of the study (OR = 0.7; Cl 95% = 0.7-0.8) were predictive o f underreporting. CONCLUSIONS: Underreporting perinatal deaths decreas ed during the study period. Deaths of newborns with low birth weight a nd who lived less than 24 hours were more underreported. The work deve loped by the Active Surveillance Registry contributed to the decense o f underreporting perinatal deaths.