Abstract
Background
Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention.
Objectives
To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM.
Search strategy
We searched CINAHL, EMBASE, Medline, Global Health and Pubmed from 2009-2016.
Selection criteria
Reports of stillbirth causes in unselective cohorts.
Data collection and analysis
Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle and high income; LIC, MIC, HIC).
Main results
reports from 50 countries (489,089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage and Other (all settings), Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC mapping obscured major causes.
Conclusion
There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. I 82 mplementation of the WHO Perinatal Mortality Audit and Review guide particularly across high burden settings is needed.
Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention.
Objectives
To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM.
Search strategy
We searched CINAHL, EMBASE, Medline, Global Health and Pubmed from 2009-2016.
Selection criteria
Reports of stillbirth causes in unselective cohorts.
Data collection and analysis
Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle and high income; LIC, MIC, HIC).
Main results
reports from 50 countries (489,089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage and Other (all settings), Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC mapping obscured major causes.
Conclusion
There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. I 82 mplementation of the WHO Perinatal Mortality Audit and Review guide particularly across high burden settings is needed.
| Original language | English |
|---|---|
| Pages (from-to) | 212-224 |
| Number of pages | 12 |
| Journal | BJOG: an international journal of obstetrics and gynaecology |
| Volume | 125 |
| Issue number | 2 |
| Early online date | 29 Nov 2017 |
| DOIs | |
| Publication status | Published - 15 Dec 2017 |
