|10 Vital Statistics Stillbirth Data
Vital Statistics Stillbirth Data
|Original source: Vital Statistics, Ontario Office of Registrar General (ORG), ServiceOntario|
Distributed by: Ontario Ministry of Health and Long Term Care (MOHLTC): IntelliHEALTH ONTARIO (IntelliHEALTH)
Suggested citation (see Data Citation Notes): Ontario Stillbirth Data [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].
- A stillbirth is defined as a product of conception weighing 500 grams or more or of 20 or more weeks gestation which, after being completely delivered, shows no sign of life. Therapeutic abortions that meet either criterion are also classified as stillbirths in Ontario (1).
- Information on stillbirths is collected by the Office of the Registrar General and is based on three forms: 1) the Notice of Stillbirth completed by the birth attendant; 2) Statement of Stillbirth completed by parents; and 3) the more detailed Medical Certificate of Stillbirth completed by the birth attendant.
- Because of data quality concerns, 1991 and 1992 data should not be used.
- The ORG supplies the stillbirth registration data to Statistics Canada for national reporting. With the ORG's approval, Statistics Canada provides the Ontario Ministry of Health with an edited and standardized dataset, which is uploaded to IntelliHEALTH.
- Stillbirths are provided in a separate data source table in IntelliHEALTH. Stillbirths by health unit are also available in the birth summary standard report.
- Data should be analyzed by the residence of the mother, not by where the stillbirth occurred.
- Prior to 2008, county, municipality, and PHU geographic locations in IntelliHEALTH for place of occurrence and place of residence of mother were derived from a municipality code supplied by ORG to Statistics Canada. LHIN was derived from municipality where possible and from postal code when the municipality was shared by several LHINs. From 2008, the place of occurrence municipality coding was discontinued by Statistics Canada and only postal code for residence was maintained. Statistics Canada now derives the municipality of residence from the postal code using the Postal Code Conversion File Plus (PCCF+) programs where there is a valid postal code. If no valid postal code is available, manual coding of residence municipality is done from any available address information on the record. Statistics Canada still uses special codes to indicate Indian Reserves within a county when a specific reserve is not identified on the registration.
- A number of data quality concerns have been identified for the stillbirth data. Stillbirths among births weighing <500g but ≥20 weeks gestation may be more prevalent due to maternal age or country of birth of the women in a jurisdiction. These stillbirths at the low end of birth weight or gestational age may not be consistently classified across jurisdictions in Ontario (2). The rate of stillbirth may be affected by temporal and regional variations in the definition of stillbirth and birth registration practices, especially for stillbirths and live births at the low end of birth weight or gestational age range (3).
- There has been an increase in the number of stillbirths in Ontario over time and an increase in the number of stillbirths with the cause of death coded as "P964 Termination of pregnancy affecting fetus and newborn" (Table 1).
- It is unknown whether the increase in the number of stillbirths with P964 as the cause of death is due to a real increase in the number of terminations which occur that meet the defining criteria of a stillbirth (≥20 weeks gestation or ≥500 grams birth weight) or whether this increase is due to the increased registration of such events.
Table 1: Number of Stillbirths in Ontario, Number of Stillbirths with P964 as Cause of Death, 2000-2009
# Stillbirths with P964 as cause
# Stillbirths excluding those with P964 as cause
n.a. - cause of death not yet available from Statistics Canada
Source: Vital Statistics Stillbirth Data, Health Analytics Branch, Ministry of Health and Long-Term Care, February 8, 2012.
- The IntelliHEALTH licensing agreement does not require suppression of small cells, but limits reporting at a level that could identify individuals, e.g. reporting at the postal code level by age and sex, regardless of the cell size. Aggregation (e.g. combining years, age groups, categories) should also be done when small numbers result in unstable rates.
- Detailed information about stillbirth data obtained through HELPS can be found in the HELPS Data Source Resource.
- Health Canada. Perinatal Health Indicators for Canada: A Resource Manual. Ottawa: Minister of Public Works and Government Services Canada, 2000. Available from: http://www.phac-aspc.gc.ca/rhs-ssg/phic-ispc/index.html
- Region of Peel. Low birth weight and stillbirth rate investigation, 2010. Available from: http://www.peelregion.ca/health/resources/lbwsir/
- Joseph KS, Allen AC, Kramer MS, Cyr M, Fair ME. Changes in the registration of stillbirths less than 500g in Canada. Paediatric Perinatal Epidemiol. 1999; 13(3):278 - 87.
|Date of last revision: January 16, 2013|