Preterm birth and neonatal mortality in China in 2011

OBJECTIVE: To determine the incidence of preterm birth, its regional distribution, and associated neonatal mortality in mainland China. METHODS: In a multicenter, hospital-based investigation of preterm birth, 2011 data were obtained from the seven administrative regions of mainland China. Between one and three subcenters were randomly selected for each administrative region, followed by secondary and tertiary hospitals within the chosen subcenters. Data were obtained from women's medical records, and obstetric and perinatal events were summarized. RESULTS: Data for 107,905 deliveries were analyzed, which included 7769 (7.1%) preterm births (occurring between 28 and 37 weeks of pregnancy). The incidence varied among regions. Late preterm birth (between 34 and 37 weeks) accounted for 5495 (70.7%) of preterm births. The neonatal mortality rate was 33 deaths per 1000 live preterm births. Of the 254 neonatal deaths, 147 (57.9%) occurred after very preterm birth (between 28 and 32 weeks). Overall, 4519 (58.2%) preterm births occurred by cesarean. CONCLUSION: The distribution of preterm birth across China is unbalanced, and neonatal mortality associated with preterm birth is high.