Parturients, delivers and newborns

Data description

Statistical presentation

The perinatal statistics and the Medical Birth Register that the statistics are based on include information on all the persons who have given birth and the children born in Finland until discharge or until the age of 7 days. The data is collected from maternity hospitals and professionals who attended deliveries outside hospital. Submitting the data to the Finnish Institute for Health and Welfare (THL) is mandatory and based on the Act on the National Institute for Health and Welfare (668/2008).
Act on the National Institute for Health and Welfare (668/2008) (in Finnish)

Perinatal statistics are available from 1987 onwards, with the latest data reported now for 2023. The data for the Medical Birth Register is currently collected once a year. Preliminary register data is published in early summer following the statistical year, and the final statistical data (including the Statistical Report) in the autumn of the year following the statistical year.
The Statistical Reports are intended for healthcare professionals, administrators, planning officials and researchers who need data on reproductive health in their work.

Relevance

The reported perinatal statistics are for the research, development and provision of maternity care, obstetrics services and neonatal care. One source of complementary information is THL’s care registers. The Medical Birth Register is widely used in research and monitoring. The data content of the register has been developed in cooperation with actors in the field.

Data content of the statistics

The statistics cover all children born in Finland and their birthing parents. Data is collected until the child is 7 days old or until discharge from hospital. The statistics include data on all live births and on stillbirths with a gestational age of at least 22+0 weeks or a minimum birth weight of 500 g.

In addition, more detailed information on small premature infants has been collected in a separate register since 2005. Small premature infants refer to live births with a weight at birth of less than 1501 g or with a gestational age at birth of less than 32+0 weeks. From 2005–2007, infants whose birth weight was exactly 1500 g were not included in this separate data collection. Small premature infants are also included in the Medical Birth Regis-ter and these statistics.

The data on deaths related to childbirth and maternal deaths is based on the causes of death information from Statistics Finland. For the years 2012–2023, the data in the Medical Birth Register is linked with the causes of death information, and the statistics are included in the Statistics Report starting from statistical year 2019.

The Statistics Report text describes the concepts used in the statistics. The Statistical Report mainly uses established international concepts and classifications (such as perineal lacerations, of which third- and fourth-degree lacerations are considered to be serious, and mode of delivery, BMI).

The statistics present numbers and percentages of parturients, deliveries and newborns as well as indicators in proportion to the population.

The age of the parturient is the age at the time of childbirth. The relative numbers of parturients are mainly in proportion to women of fertile age, or between 15 and 49 years of age. The average population is used for population ratios.

Deaths related to giving birth and maternal deaths related to birth are reported per 100,000 childbirths according to the year of birth. Maternal deaths are calculated according to the year of death and reported per 100,000 live births.

The data for each wellbeing services county is based on the parturient’s municipality of residence. The hospital-specific data, on the other hand, is based on the hospital where the childbirth took place.

Statistical processing

Source data

The statistics are based on the THL Medical Birth Register, which contains information on all births and newborns in Finland. The register contains the personal identity code of both the parturient and the born child. The hospital where the delivery takes place or the health care professional present during delivery outside hospital are obligated to submit a Medical Birth Register notification to THL.

The register data is supplemented on the basis of the Population Information System with births where no Medical Birth Register notification has been received but occurred in Finland during the statistical year according to the Population Information System data. Based on the information received from the Population Information System, notifications that are completely missing are requested from maternity hospitals. In 2023, there were ultimately 24 cases in the dataset where no information on the childbirth was found from maternity hospitals or other THL registers (most importantly the Care Register for Specialised Medical Care Terveyshilmo). At least some of the completely missing cases were likely planned home deliveries.

The register data is also supplemented with Statistics Finland data on stillborn infants and infants who died during the first four weeks of life and with data from the Population Information System on children who died during their first year of life.

Data collection

Information on each birth and child born is sent to THL electronically either as a patient information system extract or with a separate electronic form. For home deliveries, filling in the form is the responsibility of the health care professional who assisted in the delivery.

This Statistical Report includes the information submitted to THL by 23 September 2024. If necessary, THL will also accept supplements to the data after the statistics have been published. In these cases, the data is updated in connection to the next statistical publication.

Materials submitted as database extracts are sent to THL once a year, in the first half of the year following the statistical year. Notifications with the electronic form are received throughout the year.

In the future, the pace of data collection in the Medical Birth Register will be accelerated: starting 1 January 2026, data will be submitted to THL four times a year, and from 1 January 2027, data is submitted once a month. This also allows seeding up the data reporting.

Data validation

THL strives to check and correct the data as extensively as possible. The aim is to identify missing and incorrect data. A feedback report is sent to maternity hospitals annually on the information received from them, and hospitals are asked for missing cases, missing variables and possibly erroneous entries.

The data is also checked and supplemented at THL from other available register sources, the most important being the Population Information System, the Care Register for Specialised Medical Care, the Register of Primary Health Care Visits and the Register of Induced Abortions.

Information related to matters such as the place of birth and previous births is checked from the Population Information System.
The Care Register for Specialised Medical Care Terveyshilmo is used to check in-formation related to matters such as the maternity hospital, treatment time (including the date of arrival at hospital and discharge date), diagnoses and procedures.
The Care Register for Outpatient Care in Primary Health Care (Avohilmo) is used to check information including the number and timing of appointments at maternity and child health clinics.
Information related to pregnancy history is checked from the Register of Induced Abortions.

Data compilation

THL has developed automatic measures for correcting and updating the materials and electronic reports that can be used to identify errors.

The material is corrected automatically based on information such as persons’ previous deliveries and other information on each delivery in question. Missing information is supplemented partly automatically and partly on a case-by-case basis, including based on the Population Information System and care registers. Corrections are made on a case-by-case basis when reliable automatic reasoning is not possible.

Some data cannot be corrected based on data available to THL, and in these cases, corrections are requested from hospitals. Getting the data from hospitals is done with encrypted secure email.

Data revision

Data from previous statistical years is updated retroactively, if necessary, in connection with the next statistical publication. The impact of retrospective corrections on the figures has been mainly seen to be minor.

Quality assessment of the statistics

Accuracy and reliability

In 2023, there were 23 maternity hospitals operating in Finland, and the data in the Medical Birth Register was obtained from all of them. In addition, there is a small number of health care professionals in Finland who assist in home deliveries. They have been asked to fill in register notifications by means such as a separate email notification. If a person has a planned home birth without the presence of a health care professional, related notifications will likely be largely missing from the Medical Birth Register, since THL cannot obligate individual persons to submit a register notification, and information on the need to submit a notification may not reach the appropriate persons.

The information in the Medical Birth Register is based on the notifications of data providers, and the accuracy of the information depends mainly on the information received from the informant organisations.

Information sent by hospitals to THL is reviewed and corrected if necessary. Missing data and data suspected to be incorrect are checked from hospitals and corrected in the database.

A small proportion of newborns are missing from the Medical Birth Register. For this reason, the Medical Birth Register is supplemented with data on live births from the Population Information System and the Statistics Finland data on stillborn infants and infant children who died during the first four weeks of life. Infant mortality data is updated in the register from the Population Information System until the child has reached the age of one year. The coverage of the cases in the statistics is estimated to be 100% after these additions. There are wide-ranging gaps in the variable data of these additional cases from other sources because more detailed information was not available for the register.

There is an attempt to determine each child’s place of birth whenever possible. However, some children’s birthplaces remain unclear. Especially for children born outside hospital, it is sometimes unclear whether the delivery outside hospital was planned or unplanned. There are 13 such births in the data for 2023. No information on the place of birth was received for 23 births. Some of these births were probably planned home births that were not reported to THL. However, it has not been possible to identify these cases with certainty, which is why they have been recorded in these two categories in the register.

In 1990, 1996, 2004 and 2017, the data content of the register was adjusted to improve reliability and have the data content be up to date. Previous forms and data collection instructions have been archived in both paper and electronic format.

The patient information system Apotti was introduced in all maternity hospitals in the Helsinki and Uusimaa Hospital District (HUS) in February 2020. Related data recording and retrieval problems continued in 2023 and have caused some quality discrepancies in the data from the HUS area. For this reason, some data, such as statistics on gestational diabetes, is not published at the national level.

The data is checked and supplemented by THL from other register sources available, the most important ones being the Population Information System of the Digital and Population Data Services Agency (DVV), THL’s Care Register for Specialised Medical Care (Terveyshilmo), Care Register for Outpatient Care in Primary Health Care (Avohilmo) and Register of Induced Abortions and causes of death information from Statistics Finland.

Data recorded at maternity clinics or other health care units is not fully transferred to the maternity hospitals that submit the reports to THL. For this reason, information in the Medical Birth Register concerning prenatal screenings and fertility treatments is incomplete.

The detailed data content of the register and variable-specific quality observations are available in the Data resources catalogue.
Data resources catalogue

Timeliness and punctuality

The annual statistical report titled Perinatal Statistics – parturients, deliveries and newborns is made up of statistics produced by THL. The aim is to publish the advance information in June, and the actual statistical report is published in the autumn. Only the time series statistics are published as three tables in the preliminary data.

The data in the statistical report is based on the data on childbirths during the previous calendar year. Hospitals submit hospital-specific data to the Medical Birth Register by the end of January of the year following the child’s birth year at the latest. The data is completed no later than the autumn following the statistical year, after adding the data of the Digital and Population Data Services Agency and the cause of death data of Statistics Finland and checking missing details from hospitals.

Coherence and comparability

The annual statistical data presented in the Statistical Report is comparable from 1987 onwards. However, in connection with the form updates, some hospitals are unable to immediately provide all changed or added data in accordance with the new data content, and there is a transitional period of a few years related to the form updates before the new variables can be comprehensively reported on, for instance.

In 1990, 1996, 2004 and 2017, the data content of the register was adjusted to improve reliability and have the data content be up to date. Some data producers have taken a few years with the data content reform to manage comprehensively delivering all the new variables.

The patient information system Apotti was introduced in all maternity hospitals in the Helsinki and Uusimaa Hospital District (HUS) in February 2020. Related data recording and retrieval problems continued in 2023 and have caused a situation where not all variables in the HUS area are comparable with previous years, and there are some known quality discrepancies in the delivered data.

The numbers of live births and infant mortality rates reported by Statistics Finland differ somewhat from THL’s Medical Birth Register. Statistics Finland publishes the Births statistics, which are based on data from the Population Information System of the Digital and Population Data Services Agency (DVV). Statistics Finland collects data on all children born whose parturient’s habitual residence at the time of birth is Finland regardless of the place of birth, so the number also includes children born abroad. On the contrary, THL’s Medical Birth Register includes all children born in Finland, regardless of the parturient’s place of residence. The infant mortality rate is calculated by Statistics Finland according to the year of death, and the THL Medical Birth Register goes by the year of birth. THL’s figures reflect the delivery activities of hospitals, and Statistics Finland’s figures reflect the development of the Finnish population.

In statistical reporting, the figures for each maternity hospital include travel births reported by maternity hospitals and unplanned deliveries outside hospital. Planned home births, deliveries outside hospital where it is not known whether the place of delivery was planned or unplanned, and deliveries with no confirmed information about the place of delivery are not included in the reported hospital-specific figures. Before 2023, they were also partly included in hospital-specific reported figures. Since 2023, the reporting has been harmonised in this respect.

The definitions and concepts related to pregnancy and infancy are based on the ICD-10 classification of diseases and Suomalainen tautien kirjaamisen ohjekirja (available in Finnish).
Suomalainen tautien kirjaamisen ohjekirja (in Finnish)

Institutional mandate

The collection of data is based on the Act on the National Institute for Health and Welfare (688/2008). The statutory task of THL is to monitor the health and welfare of the popula-tion. The Act on the National Institute for Health and Welfare also gives THL the right to utilise data from sources such as the Population Information System and the cause of death record of Statistics Finland.
Act on the National Institute for Health and Welfare (688/2008) (in Finnish)

The perinatal statistics – parturients, deliveries and newborns are part of the statistical series of the Official Statistics of Finland (OSF), and related production of statistics com-plies with the statistics production practices of Eurostat statistics and OSF guidelines.

Data sharing and publishing

The statistics are published on the home page of the statistics at thl.fi at a time indicated in the publication calendar for statistics. The data is made public to all users at the same time. Some data is also published by municipality in the statistics and Statistics and Indicator Bank Sotkanet. Information on the publication of the statistics is sent electronically to hospitals managing deliveries.

The release of the statistics report on the THL website is also accompanied by database reports on parturients, delivery procedures and newborns. Database reports, or summar-ies and data cubes, enable users to make their own selections and retrieve information from register data. Cubes and summaries make it possible to view data by region, hospital size and hospital, both by year and by six months starting from 2007.

Data from the Medical Birth Register is also transmitted to international statistics (OECD, NOMESCO, WHO, Eurostat, the UN and Nordic perinatal statistics).

The statistical products published by THL are public, but register data containing personal data is confidential. The Finnish Social and Health Data Permit Authority Findata grants permits for using the data based on the Act on the Secondary Use of Health and Social Data (552/2019).

Confidentiality

As an authority, the Finnish Institute for Health and Welfare is obligated to report collect-ed data related to health and welfare. The data used to draw up THL’s statistics is primari-ly confidential, and personal data may not be published. The protection of processed data is based on the Act on the National Institute for Health and Welfare (688/2008), the Statistics Act (280/2004) and the Act on the Openness of Government Activities (621/1999), the EU General Data Protection Regulation (EU) 2016/679 and the Data Protection Act (1050/2018).

THL’s datasets are secured at all stages of processing. Data and information systems can only be accessed by persons who have a data permit to use certain data for clearly defined purposes. Others do not have the ability to view, process, change or delete data. Written instructions have been drawn up for ensuring the data protection of completed statistics. All THL personnel who process data have signed a non-disclosure agreement.
The privacy notice of the register can be viewed online at thl.fi
Register description

Special issues concerning the 2023 statistics

The patient information system Apotti was introduced in all maternity hospitals in the Helsinki and Uusimaa Hospital District (HUS) (Women’s Hospital, Lohja Hospital, Hyvinkää Hospital, Jorvi Hospital) in February 2020. Related data recording and retrieval problems continued in 2023 and have caused a situation where not all variables in the HUS area are comparable with previous years, and there are some quality discrepancies in the delivered data. For this reason, data related to gestational diabetes has been removed from table 1 in the appendix to the statistical report.

Quality report: Perinatal statistics – Parturients, delivers and newborns