The Causes and Prevention of Stillbirths and First Week Deaths

Baird, Dugald; Walker, James; Thomson, A. M.

doi:10.1111/j.1471-0528.1954.tb07507.x

Cited by 174 publications

(44 citation statements)

References 11 publications

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“…Cause of death groups should consist of pathophysiological entities. Many systems consist of cause of death groups that encompass clinical conditions such as pre-eclampsia [21], antepartum haemorrhage [25], breech presentation [21] and intraventricular haemorrhage [22]. Similarly intra-uterine growth restriction is a clinical condition of several causes of death, see Table 10.…”

Section: Discussionmentioning

confidence: 99%

“…These systems represent different approaches of classification with different definitions. The selected systems were as follows: the extended Wigglesworth [20], the modified Aberdeen [21], classification by Hey et al [22], by Hovatta et al [23], by de Galan-Roosen et al [24] and by Morrison and Olsen [25]. The reason for choice of the system as well as the system itself will be discussed in the following paragraphs.…”

Section: Used Classification Systems For Cause Of Deathmentioning

confidence: 99%

“…[3]. In addition, both the extended Wigglesworth and the modified Aberdeen [20,21] are most widely used throughout the world [26e31]. Wigglesworth's advocated a pathophysiological approach and the goal of the classification is to subdivide cases into groups with clear implications for priorities for prevention and alterations in clinical management.…”

Section: Placental Cause Of Deathmentioning

confidence: 99%

“…Wigglesworth's advocated a pathophysiological approach and the goal of the classification is to subdivide cases into groups with clear implications for priorities for prevention and alterations in clinical management. The modified Aberdeen is a clinicopathological classification, the first version was proposed by Baird et al [21] and aim is to classify each death in accordance with the factor which probably initiated ''the train of events ending in death''. It is almost entirely based on clinical information as in the experience of the designers of the system post-mortem examinations fail to explain cause of death in many cases.…”

Section: Placental Cause Of Deathmentioning

confidence: 99%

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A Placental Cause of Intra-uterine Fetal Death Depends on the Perinatal Mortality Classification System Used

et al. 2008

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A placental cause of intra-uterine fetal death depends on the perinatal mortality classification system used Korteweg, F.J.; Gordijn, S.J.; Timmer, Albertus; Holm, J.P.; Ravise, J.M.; Erwich, Jan Jaap H. M. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Abstract Different classification systems for the cause of intra-uterine fetal death (IUFD) are used internationally. About two thirds of these deaths are reported as unexplained and placental causes are often not addressed. Differences between systems could have consequences for the validity of vital statistics, for targeting preventive strategies and for counselling parents on recurrence risks. Our objective was to compare use of the Tulip classification with other currently used classification systems for causes of IUFD. We selected the extended Wigglesworth classification, modified Aberdeen and the classifications by Hey, Hovatta, de Galan-Roosen and Morrison. We also selected the ReCoDe system for relevant conditions, comparable to contributing factors in the Tulip classification. Panel classification for 485 IUFD cases in the different systems was performed by assessors after individual investigation of structured patient information. Distribution of cases into cause of death groups for the different systems varied, most of all for the placental and unknown groups. Systems with a high percentage of cases with an unknown cause of death and death groups consisting of clinical manifestations only are not discriminatory. Our largest cause of death group was placental pathology and classification systems without placental cause of death groups or minimal subdivision of this group are not useful in modern perinatal audit as loss of information occurs. The most frequent contributing factor was growth restriction. This illustrates the vital role of the placenta in determination of optimal fetal development. In the Tulip classification, mother, fetus and placenta are addressed together. The system has a clear defined subclassification of the placenta group, a low percentage of unknown causes and is easily applied by a multidisciplinary team. A useful classification aids future research into placental causes of IUFD.

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Section: Discussionmentioning

confidence: 99%

Section: Used Classification Systems For Cause Of Deathmentioning

confidence: 99%

Section: Placental Cause Of Deathmentioning

confidence: 99%

Section: Placental Cause Of Deathmentioning

confidence: 99%

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A Placental Cause of Intra-uterine Fetal Death Depends on the Perinatal Mortality Classification System Used

et al. 2008

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“…A limitation of much stillbirth research, including this work, is that many stillbirth classifications, such as the obstetric (Aberdeen) classification, 32 classify the majority of stillbirths as occurring for unknown reasons and hence further analysis to improve understanding is restricted. Alternative classifications of these deaths were not available for this work as for the time period under study national routinely collected data in England used only the Aberdeen classification for stillbirth.…”

Section: Classification Of Deathsmentioning

confidence: 99%

Towards reducing variations in infant mortality and morbidity: a population-based approach

Field

Boyle

Draper

et al. 2016

Programme Grants Appl Res

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BackgroundOur aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity.ObjectiveTo undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates.DesignTwo interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies.SettingCohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester.Data sourcesFor stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies.Main outcome measuresDetailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies.ResultsThe deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs.ConclusionsHealth professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background.Future workFuture work could include studies to improve our understanding of how deprivation increases the risk of mortality and morbidity in early life and investigation of longer-term outcomes and interventions in at-risk LMPT infants to improve future attainment.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Classification of Stillbirths

Reddy

Willinger

2011

Stillbirth: Prediction, Prevention and Management

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The Causes and Prevention of Stillbirths and First Week Deaths

Cited by 174 publications

References 11 publications

A Placental Cause of Intra-uterine Fetal Death Depends on the Perinatal Mortality Classification System Used

A Placental Cause of Intra-uterine Fetal Death Depends on the Perinatal Mortality Classification System Used

Towards reducing variations in infant mortality and morbidity: a population-based approach

Classification of Stillbirths

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