Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Autopsy | Research

The application of the ICD-10 for antepartum stillbirth patients in a referral centre of Eastern China: a retrospective study from 2015 to 2022

Authors: Chuan-Shou Feng, Shu-Fen Li, Hui-Hui Ju

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Login to get access

Abstract

Background

The causes of some stillbirths are unclear, and additional work must be done to investigate the risk factors for stillbirths.

Objective

To apply the International Classification of Disease-10 (ICD-10) for antepartum stillbirth at a referral center in eastern China.

Methods

Antepartum stillbirths were grouped according to the cause of death according to the International Classification of Disease-10 (ICD-10) criteria. The main maternal condition at the time of antepartum stillbirth was assigned to each patient.

Results

Antepartum stillbirths were mostly classified as fetal deaths of unspecified cause, antepartum hypoxia. Although more than half of the mothers were without an identified condition at the time of the antepartum stillbirth, where there was a maternal condition associated with perinatal death, maternal medical and surgical conditions and maternal complications during pregnancy were most common. Of all the stillbirths, 51.2% occurred between 28 and 37 weeks of gestation, the main causes of stillbirth at different gestational ages also differed. Autopsy and chromosomal microarray analysis (CMA) were recommended in all stillbirths, but only 3.6% received autopsy and 10.5% underwent chromosomal microarray analysis.

Conclusions

The ICD-10 is helpful in classifying the causes of stillbirths, but more than half of the stillbirths in our study were unexplained; therefore, additional work must be done. And the ICD-10 score may need to be improved, such as by classifying stillbirths according to gestational age. Autopsy and CMA could help determine the cause of stillbirth, but the acceptance of these methods is currently low.
Appendix
Available only for authorised users
Literature
1.
go back to reference WHO. International Statistical Classification of Diseases and Related Health Problems. Geneva, Switzerland:2004. WHO. International Statistical Classification of Diseases and Related Health Problems. Geneva, Switzerland:2004.
2.
go back to reference MacDorman MFKS. The Challenge of Fetal Mortality. National Center for Health Statistics 2009: NCHS Data Brief. No 16. MacDorman MFKS. The Challenge of Fetal Mortality. National Center for Health Statistics 2009: NCHS Data Brief. No 16.
3.
go back to reference Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587–603.CrossRefPubMed Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587–603.CrossRefPubMed
4.
go back to reference Aminu M, Unkels R, Mdegela M, et al. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG. 2014;121:141–53.CrossRefPubMed Aminu M, Unkels R, Mdegela M, et al. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG. 2014;121:141–53.CrossRefPubMed
5.
go back to reference Lakshmi ST, Thankam U, Jagadhamma P, et al. Risk factors for still birth: a hospital based case control study. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):970–4.CrossRef Lakshmi ST, Thankam U, Jagadhamma P, et al. Risk factors for still birth: a hospital based case control study. Int J Reprod Contracept Obstet Gynecol. 2017;6(3):970–4.CrossRef
6.
go back to reference World Health Organization. World health statistics 2016: monitoring health for the SDGs sustainable development goals. World Health Organization; 2016. World Health Organization. World health statistics 2016: monitoring health for the SDGs sustainable development goals. World Health Organization; 2016.
7.
go back to reference Allanson ER et al. a,b Ö Tunçalp,b J Gardosi,c,. 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. BJOG. 2016;123(12):2019–2028. Allanson ER et al. a,b Ö Tunçalp,b J Gardosi,c,. 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. BJOG. 2016;123(12):2019–2028.
10.
go back to reference WHO, UNICEF. Every newborn: an action plan to end preventable deaths. Geneva: WHO; 2014. WHO, UNICEF. Every newborn: an action plan to end preventable deaths. Geneva: WHO; 2014.
11.
go back to reference Aminu M, Bar-Zeev S, van den Broek N. Cause of and factors associated with stillbirth: a systematic review of classification systems. Acta Obstet Gynecol Scand. 2017;96(5):519–28.CrossRefPubMed Aminu M, Bar-Zeev S, van den Broek N. Cause of and factors associated with stillbirth: a systematic review of classification systems. Acta Obstet Gynecol Scand. 2017;96(5):519–28.CrossRefPubMed
12.
go back to reference Reinebrant HE, Leisher SH, Coory M, et al. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG. 2018;125:212–24.CrossRefPubMed Reinebrant HE, Leisher SH, Coory M, et al. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG. 2018;125:212–24.CrossRefPubMed
13.
go back to reference Leisher SH, Teoh Z, Reinebrant H, et al. Classification systems for causes of stillbirth and neonatal death, 2009–2014: an assessment of alignment with characteristics for an effective global system. BMC Pregnancy Childbirth. 2016;16:269.CrossRefPubMedPubMedCentral Leisher SH, Teoh Z, Reinebrant H, et al. Classification systems for causes of stillbirth and neonatal death, 2009–2014: an assessment of alignment with characteristics for an effective global system. BMC Pregnancy Childbirth. 2016;16:269.CrossRefPubMedPubMedCentral
14.
go back to reference World Health Organization. The WHO application of ICD-10 to deaths during the perinatal period: ICD-PM. Geneva, Switzerland: World Health Organization; 2016. World Health Organization. The WHO application of ICD-10 to deaths during the perinatal period: ICD-PM. Geneva, Switzerland: World Health Organization; 2016.
15.
go back to reference Stanton CLJ, Rahman H, et al. Stillbirth rates: delivering estimates in 190 countries. Lancet. 2006;367:1487–94.CrossRefPubMed Stanton CLJ, Rahman H, et al. Stillbirth rates: delivering estimates in 190 countries. Lancet. 2006;367:1487–94.CrossRefPubMed
16.
go back to reference Kiguli J, Munabi IG, Ssegujja E, et al. Stillbirths in sub-saharan Africa: unspoken grief. Lancet. 2016;38710018:e16–e8.CrossRef Kiguli J, Munabi IG, Ssegujja E, et al. Stillbirths in sub-saharan Africa: unspoken grief. Lancet. 2016;38710018:e16–e8.CrossRef
17.
go back to reference Blencowe H, Cousens S, Jassir FB, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4(2):98–108.CrossRef Blencowe H, Cousens S, Jassir FB, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4(2):98–108.CrossRef
18.
go back to reference Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH. Understanding regional differences in maternal mortality: a national case-control study in France. BJOG. 2012;119(5):573–81.CrossRefPubMed Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH. Understanding regional differences in maternal mortality: a national case-control study in France. BJOG. 2012;119(5):573–81.CrossRefPubMed
19.
go back to reference Pilkington H, Blondel B, Drewniak N, Zeitlin J. Choice in maternity care: associations with unit supply, geographic accessibility and user characteristics. Int J Health Geogr. 2012;11:35.CrossRefPubMedPubMedCentral Pilkington H, Blondel B, Drewniak N, Zeitlin J. Choice in maternity care: associations with unit supply, geographic accessibility and user characteristics. Int J Health Geogr. 2012;11:35.CrossRefPubMedPubMedCentral
20.
go back to reference Liu L-C, Wang Y-C, Yu M-H, et al. Major risk factors for stillbirth in different trimesters of pregnancy—A systematic review. Taiwan J Obstet Gynecol. 2014;53:141–5.CrossRefPubMed Liu L-C, Wang Y-C, Yu M-H, et al. Major risk factors for stillbirth in different trimesters of pregnancy—A systematic review. Taiwan J Obstet Gynecol. 2014;53:141–5.CrossRefPubMed
22.
go back to reference Lamont K, Scott NW, Jones GT, et al. Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ. 2015;350:h3080.CrossRefPubMed Lamont K, Scott NW, Jones GT, et al. Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ. 2015;350:h3080.CrossRefPubMed
23.
go back to reference Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, Coory M, Gordon A, Ellwood D, McIntyre HD, Fretts R, Ezzati M. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331-40. https://doi.org/10.1016/S0140-6736(10)62233-7. PMID: 21496916. Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, Coory M, Gordon A, Ellwood D, McIntyre HD, Fretts R, Ezzati M. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331-40. https://​doi.​org/​10.​1016/​S0140-6736(10)62233-7. PMID: 21496916.
24.
go back to reference Mahesh Bhusal N, Gautam A, Lim, et al. Factors Associated with Stillbirth among pregnant women in Nepal. J Prev Med Public Health. 2019;52(3):154–60.CrossRefPubMedPubMedCentral Mahesh Bhusal N, Gautam A, Lim, et al. Factors Associated with Stillbirth among pregnant women in Nepal. J Prev Med Public Health. 2019;52(3):154–60.CrossRefPubMedPubMedCentral
25.
go back to reference Flenady V, Middleton P, Smith GC, et al. The Lancet’s Stillbirths Series steering committee. Stillbirths: the way forward in high-income countries. Lancet (London England). 2011;377(9778):1703–17.CrossRefPubMed Flenady V, Middleton P, Smith GC, et al. The Lancet’s Stillbirths Series steering committee. Stillbirths: the way forward in high-income countries. Lancet (London England). 2011;377(9778):1703–17.CrossRefPubMed
27.
go back to reference Jessica M, Page L, Christiansen-Lindquist V, Thorsten, et al. Diagnostic tests for evaluation of Stillbirth: results from the Stillbirth Collaborative Research Network. Obstet Gynecol. 2017;129(4):699–706.CrossRef Jessica M, Page L, Christiansen-Lindquist V, Thorsten, et al. Diagnostic tests for evaluation of Stillbirth: results from the Stillbirth Collaborative Research Network. Obstet Gynecol. 2017;129(4):699–706.CrossRef
28.
go back to reference Pradhan R, Mondal S, Adhya S, Raychaudhuri G. Perinatal autopsy: a study from India. J Indian Acad Forensic Med. 2013;35:10–3. Pradhan R, Mondal S, Adhya S, Raychaudhuri G. Perinatal autopsy: a study from India. J Indian Acad Forensic Med. 2013;35:10–3.
29.
go back to reference Lewis C, Hill M, Arthurs OJ, Hutchinson C, Chitty LS, Sebire NJ. Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting. BJOG. 2018;125(2):172–81.CrossRefPubMed Lewis C, Hill M, Arthurs OJ, Hutchinson C, Chitty LS, Sebire NJ. Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting. BJOG. 2018;125(2):172–81.CrossRefPubMed
30.
go back to reference Draper E, Gallimore I, Kurinczuk J, et al. MBRRACE-UK perinatal mortality surveillance report. UK perinatal deaths for births from January to December 2016. The infant mortality and morbidity studies. Leicester: Department of Health Sciences, University of Leicester; 2018. p. 2018. Draper E, Gallimore I, Kurinczuk J, et al. MBRRACE-UK perinatal mortality surveillance report. UK perinatal deaths for births from January to December 2016. The infant mortality and morbidity studies. Leicester: Department of Health Sciences, University of Leicester; 2018. p. 2018.
31.
go back to reference Priscille Sauvegrain M, Carayol Aurélie, Piedvache, et al. Low autopsy acceptance after stillbirth in a disadvantaged French district: a mixed methods study. BMC Pregnancy Childbirth. 2019;19(1):117.CrossRefPubMedPubMedCentral Priscille Sauvegrain M, Carayol Aurélie, Piedvache, et al. Low autopsy acceptance after stillbirth in a disadvantaged French district: a mixed methods study. BMC Pregnancy Childbirth. 2019;19(1):117.CrossRefPubMedPubMedCentral
32.
go back to reference Lehner C, Harry A, Pelecanos A, et al. The feasibility of a clinical audit tool to investigate stillbirth in Australia-a single centre experience. Aust N Z J Obstet Gynaecol. 2019;59(1):59–65.CrossRefPubMed Lehner C, Harry A, Pelecanos A, et al. The feasibility of a clinical audit tool to investigate stillbirth in Australia-a single centre experience. Aust N Z J Obstet Gynaecol. 2019;59(1):59–65.CrossRefPubMed
33.
go back to reference McPherson E. Discovering the cause of stillbirth. Curr Opin Obst Gynecol. 2013;25:152–6.CrossRef McPherson E. Discovering the cause of stillbirth. Curr Opin Obst Gynecol. 2013;25:152–6.CrossRef
34.
go back to reference Martinez-Portilla RJ, Pauta M, Hawkins-Villarreal A, et al. Added value of chromosomal microarray analysis over conventional karyotyping in stillbirth work-up: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019;53(5):590–7.CrossRefPubMed Martinez-Portilla RJ, Pauta M, Hawkins-Villarreal A, et al. Added value of chromosomal microarray analysis over conventional karyotyping in stillbirth work-up: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019;53(5):590–7.CrossRefPubMed
35.
go back to reference Shobana Kubendran J, Duong F, Dong, et al. Implementing a protocol to optimize detection of chromosome abnormalities in cases of miscarriage or stillbirth at a Midwestern Teaching Hospital. Perm J. 2018;22:17–204.PubMedPubMedCentral Shobana Kubendran J, Duong F, Dong, et al. Implementing a protocol to optimize detection of chromosome abnormalities in cases of miscarriage or stillbirth at a Midwestern Teaching Hospital. Perm J. 2018;22:17–204.PubMedPubMedCentral
36.
go back to reference Kate E, Stanley J, Giordano V, Thorsten, et al. Causal genetic variants in Stillbirth. N Engl J Med. 2020;383(12):1107–16.CrossRef Kate E, Stanley J, Giordano V, Thorsten, et al. Causal genetic variants in Stillbirth. N Engl J Med. 2020;383(12):1107–16.CrossRef
Metadata
Title
The application of the ICD-10 for antepartum stillbirth patients in a referral centre of Eastern China: a retrospective study from 2015 to 2022
Authors
Chuan-Shou Feng
Shu-Fen Li
Hui-Hui Ju
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Autopsy
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06313-5

Other articles of this Issue 1/2024

BMC Pregnancy and Childbirth 1/2024 Go to the issue