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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Aleena M. Wojcieszek, Hanna E. Reinebrant, Susannah Hopkins Leisher, Emma Allanson, Michael Coory, Jan Jaap Erwich, J. Frederik Frøen, Jason Gardosi, Sanne Gordijn, Metin Gulmezoglu, Alexander E. P. Heazell, Fleurisca J. Korteweg, Elizabeth McClure, Robert Pattinson, Robert M. Silver, Gordon Smith, Zheyi Teoh, Özge Tunçalp, Vicki Flenady

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Despite 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.

Methods

A 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.

Results

The 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.

Conclusion

This 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.
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Literature
1.
Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every Newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189–205.CrossRefPubMed
2.
Heazell AE, Siassakos D, Blencowe H, Bhutta ZA, Cacciatore J, Dang N, for the Lancet Ending Preventable Stillbirths Series Study Group, et al. Stillbirths: Economic and psychosocial consequences. Lancet. 2016;387(10018):604–16.CrossRefPubMed
3.
Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, for the Lancet Ending Preventable Stillbirths Series Study Group, et al. Stillbirths: rates, risk factors and potential for progress towards. Lancet. 2016;387(10018):587–603.CrossRefPubMed
4.
Nations U. Transforming our world: The 2030 agenda for sustainable development. New York: United Nations, Department of Economic and Social Affairs; 2015.
5.
World Health Organisation. Every newborn: An action plan to end preventable deaths. Geneva: World Health Organisation; 2014.
6.
Flenady V. Epidemiology of fetal and neonatal pathology. In: Khong TY, Malcomson RDG, editors. Keeling's Fetal and Neonatal Pathology. 1st ed. New York: Springer International Publishing; 2015.
7.
Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich J, Coory M, for the Lancet Ending Preventable Stillbirths Series Study Group, et al. Stillbirths: Recall to action in high-income countries. Lancet. 2016;387(10019):691–702.CrossRefPubMed
8.
Leisher SH, Teoh Z, Reinebrant H, Allanson E, Blencowe H, Erwich JJ, et al. Seeking order amidst chaos: A systematic review of classification systems for causes of stillbirth and neonatal death, 2009–2014. BMC Pregnancy Childbirth. (in press)
9.
Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, for the Lancet Stillbirth Series steering committee, et al. Stillbirths: Where? When? Why? How to make the data count? Lancet. 2011;377(9775):1448–63.CrossRefPubMed
10.
Frøen JF, Gordijn SJ, Abdel-Aleem H, Bergsjo P, Betran A, Duke CW, et al. Making stillbirths count, making numbers talk - issues in data collection for stillbirths. BMC Pregnancy Childbirth. 2009;9:58.CrossRefPubMedPubMedCentral
11.
World Health Organisation. The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD MM. Geneva: World Health Organisation; 2012.
12.
de Galan-Roosen AE, Kuijpers JC, van der Straaten PJ, Merkus JM. Fundamental classification of perinatal death. Validation of a new classification system of perinatal death. Eur J Obstet Gynecol Reprod Biol. 2002;103(1):30–6.CrossRefPubMed
13.
Allanson E, Tunçalp Ö, Vogel J. Ending the silence: the WHO application of ICD-10 to perinatal deaths (ICD-PM). WHO Bull. 2016. In press.
14.
McKenna HP. The Delphi technique: a worthwhile research approach for nursing? J Adv Nurs. 1994;19(6):1221–5.CrossRefPubMed
15.
Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15.PubMed
16.
Rauch W. The decision Delphi. Technol Forecast Soc Chang. 1979;15(3):159–69.CrossRef
17.
Baird D, Walker J, Thomson AM. The causes and prevention of stillbirths and first week deaths. BJOG. 1954;61(4):433–48.CrossRef
18.
Wigglesworth JS. Monitoring perinatal mortality. A pathophysiological approach. Lancet. 1980;2(8196):684–6.CrossRefPubMed
19.
Ptacek I, Sebire NJ, Man JA, Brownbill P, Heazell AE. Systematic review of placental pathology reported in association with stillbirth. Placenta. 2014;35(8):552–62.CrossRefPubMed
20.
Korteweg FJ, Gordijn SJ, Timmer A, Erwich JJ, Bergman KA, Bouman K, et al. The Tulip classification of perinatal mortality: introduction and multidisciplinary inter-rater agreement. BJOG. 2006;113(4):393–401.CrossRefPubMed
21.
Frøen JF, Pinar H, Flenady V, Bahrin S, Charles A, Chauke L, et al. Causes of death and associated conditions (Codac): a utilitarian approach to the classification of perinatal deaths. BMC Pregnancy Childbirth. 2009;9:22.CrossRefPubMedPubMedCentral
22.
Varli IH, Petersson K, Bottinga R, Bremme K, Hofsjo A, Holm M, et al. The Stockholm classification of stillbirth. Acta Obstet Gynecol Scand. 2008;87(11):1202–12.CrossRefPubMed
23.
Ptacek I, Sebire NJ, Man JA, Brownbill P, Heazell AEP. Systematic review of placental pathology reported in association with stillbirth. Placenta. 2014;35(8):552–62.CrossRefPubMed
24.
Pattinson RC, editor. Saving babies 2008–2009. Seventh report on perinatal care in South Africa. Pretoria: Tshepesa Press; 2011.
25.
26.
27.
Frøen JF, Arnestad M, Frey K, Vege A, Saugstad OD, Stray-Pedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986–1995. Am J Obstet Gynecol. 2001;184(4):694–702.CrossRefPubMed
28.
Winbo IG, Serenius FH, Dahlquist GG, Källén BA. NICE, a new cause of death classification for stillbirths and neonatal deaths. Int J Epidemiol. 1998;27(3):499–504.CrossRefPubMed
29.
World Health Organization. International statistical classification of diseases and related health problems: Tenth revision, vol. 2. Geneva: World Health Organization; 2004.
30.
Jenkins D, Smith T. Applying Delphi methodology in family therapy research. Contemp Fam Ther. 1994;16(5):411–30.CrossRef
Metadata
Title
Characteristics of a global classification system for perinatal deaths: a Delphi consensus study
Authors
Aleena M. Wojcieszek
Hanna E. Reinebrant
Susannah Hopkins Leisher
Emma Allanson
Michael Coory
Jan Jaap Erwich
J. Frederik Frøen
Jason Gardosi
Sanne Gordijn
Metin Gulmezoglu
Alexander E. P. Heazell
Fleurisca J. Korteweg
Elizabeth McClure
Robert Pattinson
Robert M. Silver
Gordon Smith
Zheyi Teoh
Özge Tunçalp
Vicki Flenady
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0993-x

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