Classification of causes and associated conditions for stillbirths and neonatal deaths

Flenady, Vicki, Wojcieszek, Aleena M., Ellwood, David, Leisher, Susannah Hopkins, Erwich, Jan Jaap H. M., Draper, Elizabeth S., McClure, Elizabeth M., Reinebrant, Hanna E., Oats, Jeremy, McCowan, Lesley, Kent, Alison L., Gardener, Glenn, Gordon, Adrienne, Tudehope, David, Siassakos, Dimitrios, Storey, Claire, Zuccollo, Jane, Dahlstrom, Jane E., Gold, Katherine J., Gordijn, Sanne, Pettersson, Karin, Masson, Vicki, Pattinson, Robert, Gardosi, Jason, Khong, T. Yee, Froen, J. Frederik and Silver, Robert M. (2017) Classification of causes and associated conditions for stillbirths and neonatal deaths. Seminars in Fetal and Neonatal Medicine, 22 3: 176-185. doi:10.1016/j.siny.2017.02.009

Author Flenady, Vicki
Wojcieszek, Aleena M.
Ellwood, David
Leisher, Susannah Hopkins
Erwich, Jan Jaap H. M.
Draper, Elizabeth S.
McClure, Elizabeth M.
Reinebrant, Hanna E.
Oats, Jeremy
McCowan, Lesley
Kent, Alison L.
Gardener, Glenn
Gordon, Adrienne
Tudehope, David
Siassakos, Dimitrios
Storey, Claire
Zuccollo, Jane
Dahlstrom, Jane E.
Gold, Katherine J.
Gordijn, Sanne
Pettersson, Karin
Masson, Vicki
Pattinson, Robert
Gardosi, Jason
Khong, T. Yee
Froen, J. Frederik
Silver, Robert M.
Title Classification of causes and associated conditions for stillbirths and neonatal deaths
Journal name Seminars in Fetal and Neonatal Medicine   Check publisher's open access policy
ISSN 1878-0946
Publication date 2017-03-09
Year available 2017
Sub-type Article (original research)
DOI 10.1016/j.siny.2017.02.009
Open Access Status Not yet assessed
Volume 22
Issue 3
Start page 176
End page 185
Total pages 10
Place of publication London, United Kingdom
Publisher W.B. Saunders Ltd
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
Abstract Accurate and consistent classification of causes and associated conditions for perinatal deaths is essential to inform strategies to reduce the five million which occur globally each year. With the majority of deaths occurring in low- and middle-income countries (LMICs), their needs must be prioritised. The aim of this paper is to review the classification of perinatal death, the contemporary classification systems including the World Health Organization's International Classification of Diseases - Perinatal Mortality (ICD-PM), and next steps. During the period from 2009 to 2014, a total of 81 new or modified classification systems were identified with the majority developed in high-income countries (HICs). Structure, definitions and rules and therefore data on causes vary widely and implementation is suboptimal. Whereas system testing is limited, none appears ideal. Several systems result in a high proportion of unexplained stillbirths, prompting HICs to use more detailed systems that require data unavailable in low-income countries. Some systems appear to perform well across these different settings. ICD-PM addresses some shortcomings of ICD-10 for perinatal deaths, but important limitations remain, especially for stillbirths. A global approach to classification is needed and seems feasible. The new ICD-PM system is an important step forward and improvements will be enhanced by wide-scale use and evaluation. Implementation requires national-level support and dedicated resources. Future research should focus on implementation strategies and evaluation methods, defining placental pathologies, and ways to engage parents in the process.
Keyword Causes of death
International Classification of Diseases (ICD)
Neonatal death
Perinatal death
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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