Estimation of birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010

Objective: To estimate birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010. Study design: Data of total births in 2010 obtained from 151 level I-III hospitals in Huai'an, Jiangsu, were prospectively collected and analyzed. Results: From 61 227 birth registries (including 60 986 live births and 241 stillbirths), we derive a birth rate of 11.3 parts per thousand (of 5.4 million regional population), a male-to-female ratio of 116: 100 and valid data from 60 615 newborns. Mean birth weight (BW) was 3441 +/- 491 g with 13.6% macrosomia. Low BW was 2.8% (1691/60 372) with 8.83% mortality. Preterm rate was 3.72% (2239/60 264) with 7.61% mortality. Cesarean section rate was 52.9% (31 964/60 445), multiple pregnancy 1.8% (1088/60 567) and birth defects 6.7 parts per thousand (411/61 227). There were 97.4% healthy newborns and 2.2% (1298) requiring hospitalized after birth. The perinatal mortality was 7.7 parts per thousand (471/61 227, including 241 stillbirths, 230 early neonatal deaths). The neonatal mortality was 4.4 parts per thousand (269/60 986). The main causes of neonatal death were birth asphyxia (24.5%), respiratory diseases (21.5%), prematurity related organ dysfunction (18.5%) and congenital anomalies (7.7%), whereas incidence of congenital heart disease and respiratory distress syndrome was 8.6 parts per thousand and 6.1 parts per thousand, respectively. Conclusions: This regional birth population-based data file contains low perinatal-neonatal mortality rates, associated with low proportion of LBW and preterm births, and incidences of major neonatal disease, by which we estimate, in a nationwide perspective, in 16 million annual births, preterm births should be around 800 000, perinatal and neonatal mortality may be 128 000-144 000 and 80 000-96 000, respectively, along with 100 000 respiratory distress syndrome.