Characteristics of a global classification system for perinatal deaths: a Delphi consensus study

Abstract

BackgroundDespite the global burden of perinatal deaths, there is currently no single, globally-acceptable classification system for perinatal deaths. Instead, multiple, disparate systems are in use world-wide. This inconsistency hinders accurate estimates of causes of death and impedes effective prevention strategies. The World Health Organisation (WHO) is developing a globally-acceptable classification approach for perinatal deaths. To inform this work, we sought to establish a consensus on the important characteristics of such a system.MethodsA group of international experts in the classification of perinatal deaths were identified and invited to join an expert panel to develop a list of important characteristics of a quality global classification system for perinatal death. A Delphi consensus methodology was used to reach agreement. Three rounds of consultation were undertaken using a purpose built on-line survey. Round one sought suggested characteristics for subsequent scoring and selection in rounds two and three.ResultsThe panel of experts agreed on a total of 17 important characteristics for a globally-acceptable perinatal death classification system. Of these, 10 relate to the structural design of the system and 7 relate to the functional aspects and use of the system.ConclusionThis study serves as formative work towards the development of a globally-acceptable approach for the classification of the causes of perinatal deaths. The list of functional and structural characteristics identified should be taken into consideration when designing and developing such a system.

The WHO application of ICD‐10 to deaths during the perinatal period (ICD‐PM): results from pilot database testing in South Africa and United Kingdom

“…data). A 2014 Delphi survey of experts from 21 countries identified 17 key characteristics necessary for a perinatal death classification system; foremost, participants agreed that the overall purpose of such a system is ‘to produce data that can be used to inform strategies to prevent perinatal deaths’ . Through a consultative process, we developed The WHO application of ICD‐10 to deaths during the perinatal period: ICD‐PM .…”

“…A 2014 Delphi survey of experts from 21 countries identified 17 key characteristics necessary for a perinatal death classification system; foremost, participants agreed that the overall purpose of such a system is 'to produce data that can be used to inform strategies to prevent perinatal deaths'. 6 Through a consultative process, we developed The WHO application of ICD-10 to deaths during the perinatal period: ICD-PM. 7,8 This is closely modelled on the WHO Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: ICD-Maternal Mortality (ICD-MM), 4 and is based upon the tenth revision of the ICD (ICD-10), and follows all rules for mortality coding in ICD-10.…”

Stillbirth – a challenge for the 21st century

“…Data also need to reflect the global nature of stillbirth but to date there is no globally acceptable classification system for perinatal deaths [7, 8]. Studies presented here outline the key characteristics required for such a system including the capacity to accumulate data from both high income and low and middle income settings and for the system to be accessible by e-Health and m- Health [9]. However, of all the classification systems available none had all of the characteristics and most had fewer than half of these facets [7].…”

Application of ICD‐PM to preterm‐related neonatal deaths in South Africa and United Kingdom

“…Leisher [7][8][9][10] the WHO application of the tenth edition of the International Classification of Diseases (ICD-10) to perinatal deaths (ICD Perinatal Mortality, ICD-PM) has been developed through a consultative process. 8,9 The ICD-PM aims to be globally applicable in its approach to capturing, reporting and understanding the causes of perinatal deaths in all settings.…”