A multilayered approach for the analysis of perinatal mortality using different classification systems |
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Authors: | Sanne J Gordijn Fleurisca J Korteweg Jan Jaap HM Erwich Jozien P Holm Mariet Th van Diem Klasien A Bergman Albertus Timmer |
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Institution: | 1. Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, The Netherlands;2. Department of Paediatrics, University Medical Centre Groningen, University of Groningen, The Netherlands;3. Department of Pathology and Laboratory Medicine, University Medical Centre Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands |
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Abstract: | Many classification systems for perinatal mortality are available, all with their own strengths and weaknesses: none of them has been universally accepted. We present a systematic multilayered approach for the analysis of perinatal mortality based on information related to the moment of death, the conditions associated with death and the underlying cause of death, using a combination of representatives of existing classification systems. We compared the existing classification systems regarding their definition of the perinatal period, level of complexity, inclusion of maternal, foetal and/or placental factors and whether they focus at a clinical or pathological viewpoint. Furthermore, we allocated the classification systems to one of three categories: ‘when’, ‘what’ or ‘why’, dependent on whether the allocation of the individual cases of perinatal mortality is based on the moment of death (‘when’), the clinical conditions associated with death (‘what’), or the underlying cause of death (‘why’). A multilayered approach for the analysis and classification of perinatal mortality is possible by using combinations of existing systems; for example the Wigglesworth or Nordic Baltic (‘when’), ReCoDe (‘what’) and Tulip (‘why’) classification systems. This approach is useful not only for in depth analysis of perinatal mortality in the developed world but also for analysis of perinatal mortality in the developing countries, where resources to investigate death are often limited. |
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Keywords: | Perinatal mortality Stillbirth Classification Approach |
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