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首页> 外文期刊>British Journal of Obstetrics and Gynaecology >Termination of pregnancy among very preterm births and its impact on very preterm mortality: results from ten European population-based cohorts in the MOSAIC study.
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Termination of pregnancy among very preterm births and its impact on very preterm mortality: results from ten European population-based cohorts in the MOSAIC study.

机译：在极早产中终止妊娠及其对极早死亡率的影响：MOSAIC研究中来自十个欧洲人群的研究结果。

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OBJECTIVE: To study the impact of terminations of pregnancy (TOP) on very preterm mortality in Europe. DESIGN: European prospective population-based cohort study. SETTING: Ten regions from nine European countries participating in the MOSAIC (Models of OrganiSing Access to Intensive Care for very preterm babies) study. These regions had different policies on screening for congenital anomalies (CAs) and on pregnancy termination. POPULATION OR SAMPLE: Births 22-31 weeks gestational age. METHODS: The analysis compares the proportion of TOP among very preterm births and assesses differences in mortality between the regions. MAIN OUTCOME MEASURES: Pregnancy outcomes (termination, antepartum death, intrapartum death and live birth) and reasons for termination, presence of CAs and causes of death for stillbirths and live births in 2003. RESULTS: Pregnancy terminations constituted between 1 and 21.5% of all very preterm births and between 4 and 53% of stillbirths. Most terminations were for CAs, although some were for obstetric indications (severe pre-eclampsia, growth restriction, premature rupture of membranes). TOP contributed substantially to overall fetal mortality rates in the two regions with late second-trimester screening. There was no clear association between policies governing screening and pregnancy termination and the proportion of CAs among stillbirths and live births, except in Poland, where neonatal deaths associated with CAs were more frequent, reflecting restrictive pregnancy termination policies. CONCLUSION: Proportions of TOP among very preterm births varied widely between European regions. Information on terminations should be reported when very preterm live births and stillbirths are compared internationally since national policies related to screening for CAs and the legality and timing of medical terminations differ.
机译：目的：研究终止妊娠（TOP）对欧洲早产儿死亡率的影响。设计：欧洲前瞻性人群研究。地点：来自9个欧洲国家的10个地区参加了MOSAIC（为早产婴儿组织重症监护的模型）。这些地区在筛查先天性异常（CA）和终止妊娠方面有不同的政策。人口或样本：胎龄22-31周。方法：该分析比较了早产儿中TOP的比例，并评估了各地区之间的死亡率差异。主要观察指标：2003年妊娠结局（终止妊娠，产前死亡，产中死亡和活产）以及终止妊娠的原因，CA的存在以及死产和活产的死亡原因。结果：妊娠终止占所有妊娠的1％至21.5％早产，占死产的4％至53％。大多数终止是针对CA，尽管有些终止是针对产科适应症（严重的先兆子痫，生长受限，胎膜早破）。在孕中期进行后期筛查时，TOP对这两个地区的整体胎儿死亡率有重大贡献。在筛查和终止妊娠的政策与死产和活产中CA的比例之间没有明确的关联，波兰除外，波兰与CA相关的新生儿死亡更为频繁，这反映了限制性终止妊娠的政策。结论：欧洲各地区早产婴儿中TOP的比例差异很大。国际上比较早产和死产时应报告终止信息，因为有关筛查CA的国家政策以及医疗终止的合法性和时机不同。

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