Who Makes It to the NICU? The Association Between Prenatal Decisions and Neonatal Outcomes

Statistics are often used in various contexts in neonatal and perinatal medicine: in determining the efficacy of new treatments and innovations, in quantifying mortality and morbidity outcomes, in determining the success of a unit, or even in defending NICU budgets. In order to use statistics well, one has to know how to interpret them. But while they can be mathematically and conceptually complex, statistics are not purely objective: they are influenced by values and beliefs. This influence becomes particularly important when outcome data is used to make critical decisions, such as life and death decisions. In this chapter, we will discuss how perinatal mortality and health care professionals’ values and beliefs intersect when examining neonatal outcomes. We will suggest a classification method for perinatal deaths that enables outcome data to be ethically transparent and accurate.