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|Title:||Making stillbirths visible: a systematic review of globally reported causes of stillbirth|
|Citation:||BJOG : an international journal of obstetrics and gynaecology, 2018; 125(2):212-224|
|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|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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