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:

Ontario Stillbirth Data [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].

Report an Issue Website

Related OPHS Standards

Healthy Growth and Development

Data Notes

Data Notes (need to be split up by the subgroup...)

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).
[INSERT TABLE 1 HERE]
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.
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.

(Spare accordion to split data notes into...)

Text goes here !
And then press enter to get more bullets.

(Spare accordion to split data notes into...) >> Ask the web group if you need more accordions...

Text goes here !

Analysis Checklist

General Checklist for All Associated Indicators

The IntelliHEALTH licensing agreement does not require suppression of small cells, but caution should be used when reporting at a level that could identify individuals, (e.g. reporting at the postal code level by age and sex). Please note that privacy policies may vary by organization. Prior to releasing data, ensure adherence to the privacy policy of your organization.
Aggregation (e.g. combining years, age groups, categories) should also be considered when small numbers result in unstable rates.
Analyze mortality data by infant residence, not place of death. Analyze stillbirth data by mother's residence.
For detailed information about live birth and stillbirth data provided in by the Ontario Registrar General, refer to Vital Statistics Live Births and Vital Statistics Stillbirths resources.
HELPS Data: Historically, PHUs obtained data for live births, stillbirths, therapeutic abortions, congenital anomalies, and deaths from the Ministry of Health through HELPS (the HEalthPlanning System). Although these data are no longer commonly used, some PHUs may still be accessing these data files. Information about the data can be found in the HELPS Data Source resource.

Associated Indicators

Fertility Rates Total Fertility Rate

Crude Birth Rate Preterm Birth Rate Multiple Birth Rate

Birth Weights Age of Parent at Infant's Birth

Perinatal Mortality and Stillbirth Rates

References

Cited References

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.

Revision History

This Core Indicator Product webpage is maintained by the Reproductive Health Subgroup.

Date	Review Type	Author	Changes	PDF
January 16, 2013	Date of Last Revision	Reproductive Health Subgroup
September 15, 2019	Website Update: No Content Review	Caitlyn Paget, on behalf of the CIWG	Migrated to new website structure and format, including: Reorganized content to provide high-level information at a glance, and move in-depth analytic information into dedicated sections for users to access when needed. Moved Analysis Checklist items that are specific to the data source from the indicators pages to this data source page to reduce duplication. Crosslinked to relevant Core Indicators webpages including OPHS program standard(s) and associated indicator(s). Added Revision History table, with PDF copy of previous version for reference.

APHEO's Core Indicators Project has been developed through collaboration across the field of public health in Ontario,

to provide standardized methodology for population health assessment, to measure complex concepts of individual and community health.

Please contact core.indicators@apheo.ca for further information.

Vital Statistics Stillbirth Data (DRAFT)