Multilevel analyses of related public health indicators: The European Surveillance of Congenital Anomalies (EUROCAT) Public Health Indicators
Por:
Best, K, Rankin, J, Dolk, H, Loane, M, Haeusler, M, Nelen, V, Verellen-Dumoulin, C, Garne, E, Sayers, G, Mullaney, C, O'Mahony, M, Gatt, M, De Walle, H, Klungsoyr, K, Carolla, O, Cavero-Carbonell, C, Kurinczuk, J, Draper, E, Tucker, D, Wellesley, D, Zymak-Zakutnia, N, Lelong, N and Khoshnood, B
Publicada:
1 mar 2020
Resumen:
Background Public health organisations use public health indicators to guide health policy. Joint analysis of multiple public health indicators can provide a more comprehensive understanding of what they are intended to evaluate.
Objective To analyse variaitons in the prevalence of congenital anomaly-related perinatal mortality attributable to termination of pregnancy for foetal anomaly (TOPFA) and prenatal diagnosis of congenital anomaly prevalence.
Methods We included 55 363 cases of congenital anomalies notified to 18 EUROCAT registers in 10 countries during 2008-12. Incidence rate ratios (IRR) representing the risk of congenital anomaly-related perinatal mortality according to TOPFA and prenatal diagnosis prevalence were estimated using multilevel Poisson regression with country as a random effect. Between-country variation in congenital anomaly-related perinatal mortality was measured using random effects and compared between the null and adjusted models to estimate the percentage of variation in congenital anomaly-related perinatal mortality accounted for by TOPFA and prenatal diagnosis.
Results The risk of congenital anomaly-related perinatal mortality decreased as TOPFA and prenatal diagnosis prevalence increased (IRR 0.79, 95% confidence interval [CI] 0.72, 0.86; and IRR 0.88, 95% CI 0.79, 0.97). Modelling TOPFA and prenatal diagnosis together, the association between congenital anomaly-related perinatal mortality and TOPFA prevalence became stronger (RR 0.70, 95% CI 0.61, 0.81). The prevalence of TOPFA and prenatal diagnosis accounted for 75.5% and 37.7% of the between-country variation in perinatal mortality, respectively.
Conclusion We demonstrated an approach for analysing inter-linked public health indicators. In this example, as TOPFA and prenatal diagnosis of congenital anomaly prevalence decreased, the risk of congenital anomaly-related perinatal mortality increased. Much of the between-country variation in congenital anomaly-related perinatal mortality was accounted for by TOPFA, with a smaller proportion accounted for by prenatal diagnosis.
Filiaciones:
Best, K:
Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne, Tyne & Wear, England
Rankin, J:
Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne, Tyne & Wear, England
Dolk, H:
Ulster Univ, Inst Nursing & Hlth Res, Ctr Maternal Fetal & Infant Res, Ulster, North Ireland
Loane, M:
Ulster Univ, Inst Nursing & Hlth Res, Ctr Maternal Fetal & Infant Res, Ulster, North Ireland
Haeusler, M:
Med Univ Graz, Graz, Austria
Nelen, V:
Prov Inst Hyg, Antwerp, Belgium
Verellen-Dumoulin, C:
Eurocat Hainaut Namur, Ctr Human Genet, IPG, Charleroi, Belgium
Garne, E:
Hosp Lillebaelt, Paediat Dept, Kolding, Denmark
Sayers, G:
Hlth Serv Execut, Hlth Intelligence, Dublin, Ireland
Mullaney, C:
HSE Southeast Area, Publ Hlth Dept, Lacken, Kilkenny, Ireland
O'Mahony, M:
Hlth Serv Execut South, Dept Publ Hlth, Cork, Ireland
Gatt, M:
Dept Hlth Informat & Res, Guardamangia, Malta
De Walle, H:
Univ Groningen, Univ Med Ctr Groningen, Dept Genet, Groningen, Netherlands
Klungsoyr, K:
Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway
Carolla, O:
BioDonostia Res Inst, Publ Hlth Div Gipuzkoa, San Sebastian, Spain
:
Fdn Promot Hlth & Biomed Res Valencian Reg, Rare Dis Res Unit, Valencia, Spain
Kurinczuk, J:
Univ Oxford, Nuffield Dept Populat Hlth, Natl Perinatal Epidemiol Unit, Oxford, England
Draper, E:
Univ Leicester, Dept Hlth Sci, Leicester, Leics, England
Tucker, D:
Publ Hlth Wales, Congenital Anomaly Register & Informat Serv Wales, Swansea, W Glam, Wales
Wellesley, D:
Univ Southampton, Fac Med, Southampton, Hants, England
Wessex Clin Genet Serv, Southampton, Hants, England
Zymak-Zakutnia, N:
OMNI Net Ukraine, Khmelnytsky, Ukraine
Khmelnytsky Children Hosp, Khmelnytsky, Ukraine
Lelong, N:
Maternite Port Royal, INSERM, U1153, Ctr Biostat & Epidemiol,Obstetr Perinatal & Pedia, Paris, France
Khoshnood, B:
Maternite Port Royal, INSERM, U1153, Ctr Biostat & Epidemiol,Obstetr Perinatal & Pedia, Paris, France
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