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Type: Journal article
Title: Making stillbirths visible: a systematic review of globally reported causes of stillbirth
Author: Reinebrant, H.
Leisher, S.
Coory, M.
Henry, S.
Wojcieszek, A.
Gardener, G.
Lourie, R.
Ellwood, D.
Teoh, Z.
Allanson, E.
Blencowe, H.
Draper, E.
Erwich, J.
Frøen, J.
Gardosi, J.
Gold, K.
Gordijn, S.
Gordon, A.
Heazell, A.
Khong, T.
et al.
Citation: BJOG : an international journal of obstetrics and gynaecology, 2018; 125(2):212-224
Publisher: Wiley
Issue Date: 2018
ISSN: 1470-0328
Statement of
HE Reinebrant, SH Leisher, M Coory, S Henry, AM Wojcieszek, G Gardener, R Lourie, D Ellwood, Z Teoh, E Allanson, H Blencowe, ES Draper, JJ Erwich, JF Frøen, J Gardosi, K Gold, S Gordijn, A Gordon, AEP Heazell, TY Khong, F Korteweg, JE Lawn, EM McClure, J Oats, R Pattinson, K Pettersson, D Siassakos, RM Silver, GCS Smith, Ö Tunçalp, V Flenady
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 to 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 countries; LIC, MIC, HIC). Main results: Eighty-five 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. Conclusions 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. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings.
Keywords: Cause of death; classification; ICD; stillbirth, systems
Rights: © 2017 Royal College of Obstetricians and Gynaecologists
RMID: 0030078421
DOI: 10.1111/1471-0528.14971
Grant ID:
Appears in Collections:Obstetrics and Gynaecology publications

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