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Table 4 Actions to improve national preterm birth rate data

From: Born Too Soon: The global epidemiology of 15 million preterm births

Definition consistency Numerator (number of preterm births)
Consensus on definition of preterm birth for international comparison, specifying gestational age Simplified, lower cost, consistent measures of gestational age (GA) Widespread use and recording of GA
  Consistent inclusion of all live births of all gestations or weight, and noting if singleton or multiple births and noting the proportion that are under 500 g/22 weeks and under 1,000 g/28 weeks for international comparison Also record all stillbirths from 500 g/22 weeks and 1,000 g/28 weeks (whilst collecting by other national definition for stillbirth if different e.g., 20 weeks in United States)
  Denominator (number of births)
  Consistent measurement of all live births of all gestations noting if less than 22 weeks and if singleton or multiple births
  Also record all stillbirths
Actions to improve the data Focus on capture and consistency:
  Gestational age and birthweight recording for all births
  Improve reporting of neonatal cause of death with preterm as direct cause and as risk factor (counting deaths of preterm babies who die from other causes)
  Collection of impairment data e.g., cerebral palsy and retinopathy of prematurity (ROP) rates according to a basic minimum dataset to increase consistency
  For settings where additional capacity available:
  Improve measurement e.g. gestational age assessment using early, high-quality ultrasound scan, development and refinement of improved gestational age assessment tools for use in low-resource settings
  Increase the granularity of the data:
  Record if provider-initiated, e.g., cesarean birth, or spontaneous and the basic phenotype, e.g. infection/relative contribution of each cause especially multiple births
  Improve the linkage of data to action: e.g., collating data by gender, socioeconomic status, ethnicity, subnational e.g. state
  Impairment data according to a more comprehensive standard dataset
Data for action Set goals for national and global level for
  1. Reduction of deaths amongst preterm babies by 2025
  2. Reduction of preterm birth rates by 2025
  Regular reporting of preterm birth rates and preterm-specific mortality rates at national level and to global level to track against goals
  1. Note that weight is the preferred measure in ICD 10, but GA is commonly used now. The weight and GA "equivalents" are approximate.