Arbeitsbereich

Bevölkerung und Gesundheit

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Projekt

Recent Developments in Perinatal Health Care and Mortality (Dissertation)

Ausführliche Beschreibung

In high-income countries, stillbirth and infant mortality rates have been declining for several decades. In recent years, however, progress has slowed in some countries, with rates plateauing or even increasing slightly. While declines are continuing in many settings, other countries are struggling to achieve further improvements. These developments highlight the need to better understand how perinatal mortality is shaped by changing social, demographic, and health care contexts in high-income societies.

Fetal and infant mortality represent profound human losses. For families, the death of a child is deeply traumatic, while for societies, these deaths remain important indicators of population health and the effectiveness of health care systems. Historically, perinatal mortality has been closely linked to the quality and accessibility of maternal and obstetric care. Changes in health care provision, economic pressures on health systems, and shifts in population composition may all influence how perinatal outcomes develop over time.

This project examines recent developments in fetal and infant mortality in high-income countries, focusing on how these trends are structured by social inequalities, demographic change, and health care systems. In particular, it investigates disparities related to maternal age, migration background, and educational attainment, as well as the role of changing access to obstetric care. The project is structured in six parts:

The first study investigates stillbirth trends in Germany, and examines how the COVID-19 pandemic might have affected these developments.

The second study analyses differences in stillbirth rates across social groups in Germany, focusing on disparities related to maternal age and migration background.

The third study extends the analysis to a comparative European perspective by examining stillbirth trends and disparities across 24 European countries. It investigates how differences in maternal age structure and in the prevalence of multiple births shape these trends.

The fourth study examines changing spatial access to obstetric care in Germany by analyzing developments in driving time to the nearest maternity ward.

The fifth study analyses fetal and infant mortality along a shared gestational age scale, investigating differences across biological and social strata as well as variations by cause of death.

The sixth study focuses on disparities in perinatal mortality by maternal age. It examines when these differences emerge across the early life course, and it explores the mechanisms underlying these disparities by analyzing the causes of death and the mediating role of maternal education.

Together, these studies provide a comprehensive perspective on recent trends in perinatal mortality, the social and demographic factors shaping these outcomes, and the changing health care environments in which they occur.

Schlagworte:

Geburtenentwicklung, Gesundheitsversorgung, Public Health, Medizin und Epidemiologie

Schlagworte (Region):

Deutschland, Europa, Vereinigte Staaten