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Epidemiology
Original research
Comparing regional neonatal mortality rates: the influence of registration of births as live born for birth weight <500 g in Taiwan
  1. Liang-Yi Wang1,
  2. Yu-Shan Chang2,
  3. Fu-Wen Liang3,
  4. Yung-Chieh Lin2,
  5. Yuh-Jyh Lin2,
  6. Tsung-Hsueh Lu1,
  7. Chyi-Her Lin2
  1. 1 Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
  2. 2 Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
  3. 3 Department of Public Health, Kaohsiung Medical University College of Health Science, Kaohsiung, Taiwan
  1. Correspondence to Dr Tsung-Hsueh Lu; robertlu{at}mail.ncku.edu.tw

Abstract

Objective To investigate regional variation in the registration of births (still+live) as live born for birth weight <500 g and the impact on the city/county ranking of neonatal mortality rate (NMR) in Taiwan.

Design Population-based cross-sectional ecological study.

Setting 20 cities/counties in Taiwan.

Participants Registered births for birth weight <500 g and neonatal deaths in 2015–2016.

Main outcome measures City/county percentage of births <500 g registered as live born and ranking of city/county NMR (deaths per 1000 live births) including and excluding live births <500 g.

Results The percentage of births <500 g registered as live born ranged from 0% in Keelung City (0/26) and Penghu County (0/4) to 20% in Taipei City (112/558), 24% in Hsinchu County (5/21) and 28% in Hualien County (9/32). The change in city/county ranking of NMR from including to excluding live births <500 g was most prominent in Taipei City (from the 15th to the 1st) followed by Kaohsiung City (from the 18th to the 14th).

Conclusions The city/county NMR in Taiwan is influenced by variation in the registration of live born for births with uncertain viability. We recommend presenting city/county NMR using both criteria (with or without minimum threshold of gestation period or birth weight) for better interpretation of the findings of comparisons of city/county NMR.

  • epidemiology
  • statistics
  • mortality
  • neonatology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjpo-2019-000526

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    Footnotes

    • Contributors LYW and THL conceived the study, guided the analyses and wrote the article draft. YSC and FWL collected and analysed the data. YCL, YJL and CHL critically revised the draft. LYW and THL were the guarantors of the study.

    • Funding This study was funded by the Ministry of Health and Welfare (M07K1003).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open access repository.