Luxembourg’ participation at EuroPeristat 2015 report - main results and outcomes

Authors: Guy Weber, Ministry of Health, Directorate of Health, Epidemiology and Statistics Unit and Aline Lecomte, Luxembourg Institute of Health, Department of Population Health, Luxembourg

Luxembourg has developed an exhaustive, voluntary registry on perinatal health.

With about 6500 births per year, plurennial statistics are privileged in Luxembourg, just as in other small countries, to better assess the occurrence of rare events such as maternal mortality and stillbirth. Indeed, there are high year-to-year random variations. Specifically for maternal mortality, the Grand Duchy would need to collect data on maternal deaths over half a century or more to provide figures as robust as those of the largest EU countries.

The calculation of harmonised indicators at European level and the comparison of results with all participating countries represent a real added-value for Luxembourg’s public health political stakeholders.

In 2019, Luxembourg is able to calculate all 10 core and 20 recommended indicators.

In 2015, the multiple birth rate was reported to be 17.9‰ for twins and 0.4‰ for triplets or more. The national birth rate is high for primiparous women (47.6%) and for primiparous women who delivered after 35 (27.4%); this birth rate for primiparous women is steadily increasing since 2010 where it was 23.3%. 10.7% of smoking women continue smoking during the 3rd trimester of pregnancy. A decrease is noted compared with the result published in 2010, which was 12.5%.

Luxembourg has a high rate of caesarean sections (32.7%) as well as a high rate of instrumental vaginal delivery (11.2%). The percentages of caesarean delivery without labour/elective (16.9%) and caesarean section during labour/emergency (15.8%) are similar. An overall increase of caesarean delivery occurred when comparing with data from 2010 (30.0%).

In 2014, the perinatal national steering committee established national recommendations on elective caesarean section after 37 weeks of pregnancy that were subsequently validated by the scientific council “Conseil Scientifique dans le Domaine de la Santé”. To create awareness, a flyer presenting the major advantages and risks of caesarean section based on the new recommendations was designed and since then is distributed to all future new parents.

The preterm live birth rate (< 37 weeks) is relatively high in Luxembourg (7.3%): 1.1 % for births before 32 weeks of pregnancy and 6.3% for births between 32 to 36 weeks of pregnancy.

There was an increase in the stillbirth rate at ≥28 weeks of gestation between 2010 (2.9‰) and 2015 (3.9‰), but this is a rare event and variations from year to year are expected. Neonatal mortality at ≥22 weeks remains relatively low: 1.3‰ for early neonatal mortality and 0.3‰ for late neonatal mortality.

The infant mortality rate for live births is 2.3‰. The national infant mortality rate is probably not entirely accurate: it is estimated that 14% of child deaths occur abroad when infants are transferred for care to specialised centres in neighbouring countries. Cause of death registries are not notified about these deaths and they are not included in the statistics presented here.