23 results on '"Susannah Hopkins Leisher"'
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2. Ending preventable stillbirths and improving bereavement care: a scorecard for high- and upper-middle income countries
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Esti Charlotte de Graaff, Susannah Hopkins Leisher, Hannah Blencowe, Harriet Lawford, Jillian Cassidy, Paul Richard Cassidy, Elizabeth S. Draper, Alexander E. P. Heazell, Mary Kinney, Paula Quigley, Claudia Ravaldi, Claire Storey, Alfredo Vannacci, the E. P. S. in High-Resource Countries Scorecard Collaboration Group, and Vicki Flenady
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Stillbirth ,High-income countries ,High-resource setting ,Scorecard ,Equity ,Stigma ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Despite progress, stillbirth rates in many high- and upper-middle income countries remain high, and the majority of these deaths are preventable. We introduce the Ending Preventable Stillbirths (EPS) Scorecard for High- and Upper Middle-Income Countries, a tool to track progress against the Lancet’s 2016 EPS Series Call to Action, fostering transparency, consistency and accountability. Methods The Scorecard for EPS in High- and Upper-Middle Income Countries was adapted from the Scorecard for EPS in Low-Income Countries, which includes 20 indicators to track progress against the eight Call to Action targets. The Scorecard for High- and Upper-Middle Income Countries includes 23 indicators tracking progress against these same Call to Action targets. For this inaugural version of the Scorecard, 13 high- and upper-middle income countries supplied data. Data were collated and compared between and within countries. Results Data were complete for 15 of 23 indicators (65%). Five key issues were identified: (1) there is wide variation in stillbirth rates and related perinatal outcomes, (2) definitions of stillbirth and related perinatal outcomes vary widely across countries, (3) data on key risk factors for stillbirth are often missing and equity is not consistently tracked, (4) most countries lack guidelines and targets for critical areas for stillbirth prevention and care after stillbirth and have not set a national stillbirth rate target, and (5) most countries do not have mechanisms in place for reduction of stigma or guidelines around bereavement care. Conclusions This inaugural version of the Scorecard for High- and Upper-Middle Income Countries highlights important gaps in performance indicators for stillbirth both between and within countries. The Scorecard provides a basis for future assessment of progress and can be used to help hold individual countries accountable, especially for reducing stillbirth inequities in disadvantaged groups.
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- 2023
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3. Counting stillbirths and COVID 19—there has never been a more urgent time
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Caroline S E Homer, Susannah Hopkins Leisher, Neelam Aggarwal, Joseph Akuze, Delly Babona, Hannah Blencowe, John Bolgna, Richard Chawana, Aliki Christou, Miranda Davies-Tuck, Rakhi Dandona, Sanne Gordijn, Adrienne Gordon, Rafat Jan, Fleurisca Korteweg, Salome Maswime, Margaret M Murphy, Paula Quigley, Claire Storey, Lisa M Vallely, Peter Waiswa, Clare Whitehead, Jennifer Zeitlin, and Vicki Flenady
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Public aspects of medicine ,RA1-1270 - Published
- 2021
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4. Stillbirth
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Margaret M. Murphy, Rakhi Dandona, Hannah Blencowe, Paula Quigley, Susannah Hopkins Leisher, Claire Storey, Dimitrios Siassakos, Alexander Heazell, and Vicki Flenady
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Stillbirth, the death of a baby at or before the time of birth, affects at least 2 million families around the world each year. The global burden of stillbirth is borne unequally, with families in Sub-Saharan Africa, South East Asia, and South America most affected. Although similar to the numbers of newborn deaths, stillbirth is only recently being addressed as a global public health issue. Utilizing a systems-thinking approach to stillbirth is necessary to address the inherent complexities in reducing its burden. This chapter discusses addressing the complexities of stillbirth using the WHO Health Systems Framework and provides salient examples from global partners who are all working to reduce the ongoing deaths from stillbirth.
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- 2022
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5. Parents’ experiences of care offered after stillbirth: An international online survey of high and middle‐income countries
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Margaret M. Murphy, Jan Jaap H. M. Erwich, Alexander E. P. Heazell, Alfredo Vannacci, Claudia Ravaldi, Katherine J. Gold, Mechthild M. Gross, Frances M. Boyle, Claire Storey, Susannah Hopkins Leisher, Aleena M. Wojcieszek, Vicki Flenady, Dell Horey, Paul Cassidy, Jillian Cassidy, and Dimitrios Siassakos
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Parents ,030219 obstetrics & reproductive medicine ,Perinatal bereavement ,business.industry ,Middle income countries ,Obstetrics and Gynecology ,Odds ratio ,Stillbirth ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Humans ,Social consequence ,Medicine ,Female ,030212 general & internal medicine ,Bereavement Care ,business ,Developing Countries ,High income countries ,Bereavement ,Demography - Abstract
Background Stillbirth, the death of a baby before birth, is associated with significant psychological and social consequences that can be mitigated by respectful and supportive bereavement care. The absence of high-level evidence to support the broad scope of perinatal bereavement practices means that offering a range of options identified as valued by parents has become an important indicator of care quality. This study aimed to describe bereavement care practices offered to parents across different high-income and middle-income countries. Methods An online survey of parents of stillborn babies was conducted between December 2014 and February 2015. Frequencies of nine practices were compared between high-income and middle-income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high-income and middle-income countries. Results Over three thousand parents (3041) with a self-reported stillbirth in the preceding five years from 40 countries responded. Fifteen countries had atleast 40 responses. Significant differences in the prevalence of offering nine bereavement care practices were reported by women in high-income countries (HICs) compared with women in middle-income countries (MICs). All nine practices were reported to occur significantly more frequently by women in HICs, including opportunity to see and hold their baby (OR = 4.8, 95% CI 4.0-5.9). The widespread occurrence of all nine practices was reported only for The Netherlands. Conclusions Bereavement care after stillbirth varies between countries. Future research should look at why these differences occur, their impact on parents, and whether differences should be addressed, particularly how to support effective communication, decision-making, and follow-up care.
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- 2021
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6. Counting stillbirths and COVID 19-there has never been a more urgent time
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Rakhi Dandona, Rafat Jan, Fleurisca J. Korteweg, Salome Maswime, Hannah Blencowe, Miranda Davies-Tuck, Claire Storey, Clare Whitehead, Peter Waiswa, Vicki Flenady, John Bolgna, Susannah Hopkins Leisher, Richard Chawana, Paula Quigley, Lisa M Vallely, Aliki Christou, Caroline S.E. Homer, Joseph Akuze, Sanne J. Gordijn, Delly Babona, Neelam Aggarwal, Jennifer Zeitlin, Adrienne Gordon, Margaret M. Murphy, Burnet Institute [Melbourne, Victoria], International Stillbirth Alliance [Millburn, NJ, USA] (ISA), Columbia University [New York], University of Queensland [Brisbane], Post Graduate Institute of Medical Education & Research [Chandigarh, India], London School of Hygiene and Tropical Medicine (LSHTM), Makerere University [Kampala, Ouganda] (MAK), St Mary's Hospital Vunapope [Kokopo, Papua New Guinea], Modillon Hospital [Madang, Papua New Guinea], University of the Witwatersrand [Johannesburg] (WITS), Biovac [Cape Town, South Africa], The University of Sydney, Hudson Institute of Medical Research [Clayton], Monash University [Clayton], Indian Institute of Public Health of Delhi, Washington State University (WSU), University of Groningen [Groningen], Royal Prince Alfred Hospital [Sydney, Australia], The Aga Khan University, University Medical Center Groningen [Groningen] (UMCG), University of Cape Town, University College Cork (UCC), Technical Assistance to Strengthen Capabilities Project [London, UK], DAI Global Health [London, UK], University of New South Wales [Sydney] (UNSW), Papua New Guinea Institute for Medical Research (PNGIMR), The Royal Melbourne Hospital, Mercy Hospital For Women [Heidelberg, VIC, Australia], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Southern Queensland (USQ), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and PHILIBERT, Marianne
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2019-20 coronavirus outbreak ,Pediatrics ,medicine.medical_specialty ,Pregnancy risk ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,[SDV]Life Sciences [q-bio] ,MEDLINE ,medicine.disease_cause ,Global Health ,03 medical and health sciences ,0302 clinical medicine ,Lockdown ,Global health ,Medicine ,Humans ,030212 general & internal medicine ,Neonatal care ,ComputingMilieux_MISCELLANEOUS ,Coronavirus ,030219 obstetrics & reproductive medicine ,business.industry ,lcsh:Public aspects of medicine ,COVID-19 ,lcsh:RA1-1270 ,General Medicine ,Stillbirth ,Child mortality ,[SDV] Life Sciences [q-bio] ,0605 Microbiology, 1117 Public Health and Health Services ,business ,Stillbirths - Abstract
International audience; No abstract available
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- 2020
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7. Systematic review: fetal death reporting and risk in Zika-affected pregnancies
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Susannah Hopkins Leisher, Hanna E. Reinebrant, Louise Kuhn, Stephanie Shiau, Arin A. Balalian, Vicki Flenady, and Stephen Morse
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medicine.medical_specialty ,030231 tropical medicine ,Abortion ,Zika virus ,Miscarriage ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Medicine ,Humans ,Pregnancy Complications, Infectious ,reproductive and urinary physiology ,biology ,business.industry ,Obstetrics ,Zika Virus Infection ,Public Health, Environmental and Occupational Health ,Absolute risk reduction ,Pregnancy Outcome ,Zika Virus ,Stillbirth ,medicine.disease ,biology.organism_classification ,Abortion, Spontaneous ,Infectious Diseases ,Relative risk ,embryonic structures ,Microcephaly ,Gestation ,Parasitology ,Female ,business ,Live birth - Abstract
Zika virus is linked to several adverse pregnancy outcomes. We assessed whether Zika infection during pregnancy is associated with increased risk of foetal death (miscarriage, stillbirth, abortion) and whether there is incomplete reporting of such deaths.We searched PubMed, Embase, CINAHL, Web of Science and LILACS for studies reporting Zika-affected completed pregnancies (ending in foetal death or live birth), excluding studies whose aim required live birth. Studies 'allowed' foetal death if their populations were defined to encompass both live births and foetal deaths, regardless of whether deaths were actually found. Two authors independently extracted data and assessed study quality. Foetal death absolute and relative risks in Zika-affected vs. unaffected pregnancies were calculated.We found 108 reports including 24 699 completed, Zika-affected pregnancies. The median absolute risk in 37 studies of completed, Zika-affected pregnancies was 6.3% (IQR 3.2%, 10.6%) for foetal death and 5.9% (IQR 0%, 29.1%) for non-fatal adverse outcomes (e.g. microcephaly). More studies allowed non-fatal adverse outcomes (95%) than foetal death (58%). Of studies which allowed them, 94% found at least one foetal death. In 37% of reports, it was unknown whether foetal deaths were allowed. Only one study had sufficient data to estimate a foetal death relative risk (11.05, 95% CI 3.43, 35.55).Evidence was insufficient to determine whether foetal death risk is higher in Zika-affected pregnancies, but suggests quality of foetal death reporting should be improved, including stating whether foetal deaths were found, how many, and at what gestational ages, or justifying their exclusion.Le virus Zika est lié à plusieurs issues défavorables de la grossesse. Nous avons évalué si l'infection à Zika pendant la grossesse était associée à un risque accru de mort fœtale (fausse couche, mortinaissance, avortement) et s'il y avait une déclaration incomplète de ces décès. MÉTHODES: Nous avons recherché dans PubMed, EMBASE, Cinahl, Web of Science et LILACS des études rapportant des grossesses terminées touchées par le virus Zika (se terminant par une mort fœtale ou une naissance vivante), à l'exclusion des études dont l'objectif nécessitait une naissance vivante. Les études «autorisaient» la mort fœtale si leur population était définie comme englobant à la fois les naissances vivantes et les décès fœtaux, indépendamment du fait que des décès aient été effectivement constatés. Deux auteurs ont indépendamment extrait les données et évalué la qualité des études. Les risques absolus et relatifs de mortalité fœtale dans les grossesses affectées par Zika par rapport aux grossesses non affectées ont été calculés. RÉSULTATS: Nous avons trouvé 108 reports dont 24.699 grossesses terminées et affectées par le virus Zika. Le risque médian absolu dans 37 études portant sur des grossesses terminées affectées par Zika était de 6,3% (IQR 3,2%, 10,6%) pour la mort fœtale et de 5,9% (IQR 0%, 29,1%) pour les issues indésirables non mortelles (par exemple microcéphalie). Plus d'études ont «autorisé» des résultats indésirables non mortels (95%) que la mort fœtale (58%). Parmi les études qui les ont «autorisé», 94% ont trouvé au moins un décès fœtal. Dans 37% des rapports, il n’est pas indiqué si la mort fœtale avait été «autorisée». Une seule étude contenait des données suffisantes pour estimer un risque relatif de mort fœtale (11,05 ; IC95%: 3,43, 35,55).Les données étaient insuffisantes pour déterminer si le risque de mort fœtale est plus élevé dans les grossesses touchées par le virus Zika, mais suggèrent que la qualité des reports sur les décès fœtaux devrait être améliorée, notamment en indiquant si des décès fœtaux ont été constatés, combien et à quel âge gestationnel, ou justifiant leur exclusion.
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- 2020
8. Impact of COVID-19 on maternal and child health
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Aliki Christou, Elizabeth M. McClure, Claire Storey, Sara L Nam, Hannah Blencowe, Mary V Kinney, Susannah Hopkins Leisher, and Paula Quigley
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Maternal and child health ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Developing country ,General Medicine ,Child health ,Article ,Child mortality ,Environmental health ,Medicine ,business ,Coronavirus Infections - Published
- 2020
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9. Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia
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Adrienne Gordon, Vicki L. Clifton, Madeline Forbes, Aleena M. Wojcieszek, Susannah Hopkins Leisher, Jonathan M. Morris, Philippa Middleton, Jessica Sexton, Caroline S.E. Homer, Sarah Henry, Emily J. Callander, Euan M. Wallace, Frances M. Boyle, Hannah Blencowe, David Ellwood, Sailesh Kumar, Michael Coory, Vicki Flenady, Leigh Brezler, and Miranda Davies-Tuck
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Parents ,Economic growth ,medicine.medical_specialty ,media_common.quotation_subject ,Patient Advocacy ,Patient advocacy ,Excellence ,Pregnancy ,Political science ,Maternity and Midwifery ,medicine ,Humans ,Fetal Death ,reproductive and urinary physiology ,Health policy ,media_common ,Public health ,Health Policy ,Research ,Australia ,COVID-19 ,Obstetrics and Gynecology ,Stillbirth rate ,Stillbirth ,female genital diseases and pregnancy complications ,Disadvantaged ,Coronavirus ,Work (electrical) ,population characteristics ,Female ,Psychosocial - Abstract
Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia's late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia's NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.
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- 2020
10. Meeting abstracts from the International Stillbirth Alliance Conference 2017
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Rohan Lourie, Susannah Hopkins Leisher, Hannah Blencowe, Sarah Henry, Hanna E. Reinebrant, Aleena M. Wojcieszek, Vicki Flenady, and Michael Coory
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Gynecology ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Bibliometric analysis ,030504 nursing ,business.industry ,Obstetrics ,Early Pregnancy Loss ,Obstetrics and Gynecology ,Abortion ,medicine.disease ,Miscarriage ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,0305 other medical science ,business - Published
- 2017
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11. Classification of causes and associated conditions for stillbirths and neonatal deaths
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Jeremy Oats, Hanna E. Reinebrant, Sanne J. Gordijn, Vicki Masson, David I. Tudehope, Robert Clive Pattinson, Dimitrios Siassakos, Karin Pettersson, Katherine J. Gold, Jane Zuccollo, Robert M. Silver, Jason Gardosi, Adrienne Gordon, Jane E. Dahlstrom, Lesley M. E. McCowan, Claire Storey, Susannah Hopkins Leisher, Jan Jaap H. M. Erwich, Elizabeth M. McClure, J. Frederik Frøen, Alison L. Kent, T. Yee Khong, Glenn Gardener, David Ellwood, Aleena M. Wojcieszek, Elizabeth S Draper, Vicki Flenady, and Reproductive Origins of Adult Health and Disease (ROAHD)
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Process (engineering) ,PROFESSIONALS ,Neonatal death ,International Classification of Diseases (ICD) ,PERINATAL-MORTALITY ,Global Health ,World Health Organization ,PERIOD ICD-PM ,World health ,03 medical and health sciences ,0302 clinical medicine ,International Classification of Diseases ,Pregnancy ,Risk Factors ,Cause of Death ,Environmental health ,Evaluation methods ,Humans ,Medicine ,030212 general & internal medicine ,Developing Countries ,Causes of death ,UNITED-KINGDOM ,030219 obstetrics & reproductive medicine ,Perinatal mortality ,business.industry ,Developed Countries ,Infant, Newborn ,IDENTIFY ,Stillbirth ,Classification ,SOUTH-AFRICA ,MATERNAL CONDITION ,Pediatrics, Perinatology and Child Health ,Female ,Perinatal death ,QUALITY-OF-CARE ,business ,CONSENSUS ,SYSTEM ,Perinatal Deaths - Abstract
Accurate and consistent classification of causes and associated conditions for perinatal deaths is essential to inform strategies to reduce the five million which occur globally each year. With the majority of deaths occurring in low- and middle-income countries (LMICs), their needs must be prioritised. The aim of this paper is to review the classification of perinatal death, the contemporary classification systems including the World Health Organization's International Classification of Diseases Perinatal Mortality (ICD-PM), and next steps. During the period from 2009 to 2014, a total of 81 new or modified classification systems were identified with the majority developed in high-income countries (HICs). Structure, definitions and rules and therefore data on causes vary widely and implementation is suboptimal. Whereas system testing is limited, none appears ideal. Several systems result in a high proportion of unexplained stillbirths, prompting HICs to use more detailed systems that require data unavailable in low-income countries. Some systems appear to perform well across these different settings. ICD-PM addresses some shortcomings of ICD-10 for perinatal deaths, but important limitations remain, especially for stillbirths. A global approach to classification is needed and seems feasible. The new. ICD-PM system is an important step forward and improvements will be enhanced by wide-scale use and evaluation. Implementation requires national-level support and dedicated resources. Future research should focus on implementation strategies and evaluation methods, defining placental pathologies, and ways to engage parents in the process. (C) 2017 Elsevier Ltd. All rights reserved.
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- 2017
12. Concurrent Abstracts Session One Monday 23rd May 1330-1500
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Rohan Lourie, Glenn Gardener, J. F. Froen, Vicki Flenady, Alexander E. P. Heazell, B. Silver, Gordon C. S. Smith, Michael Coory, Susannah Hopkins Leisher, Z. Teoh, Hanna E. Reinebrant, Aleena M. Wojcieszek, Jan Jaap H. M. Erwich, and A. Ghazala
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03 medical and health sciences ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,Pediatrics, Perinatology and Child Health ,Income country ,Medicine ,Demographic economics ,030212 general & internal medicine ,business ,Task (project management) - Published
- 2016
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13. Care in subsequent pregnancies following stillbirth: an international survey of parents
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Paul Cassidy, Mechthild M. Gross, Tracey A Mills, Frances M. Boyle, Jillian Cassidy, Philippa Middleton, Alexander E. P. Heazell, Vicki Flenady, J. Ruidiaz, Karin Pettersson, Robert M. Silver, José M. Belizán, C. Storey, Aleena M. Wojcieszek, Dimitrios Siassakos, David Ellwood, Claudia Ravaldi, Alfredo Vannacci, Jan Jaap H. M. Erwich, Margaret M. Murphy, Lynn Farrales, Susannah Hopkins Leisher, and Reproductive Origins of Adult Health and Disease (ROAHD)
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Male ,Parents ,genetic structures ,Epidemiology ,Collaborative Care ,Medicina Clínica ,0302 clinical medicine ,Recurrence ,Surveys and Questionnaires ,Psychology ,030212 general & internal medicine ,media_common ,RISK ,OUTCOMES ,030219 obstetrics & reproductive medicine ,Obstetrics ,DEATH ,Obstetrics and Gynecology ,Gestational age ,Prenatal Care ,Middle Aged ,RECURRENT STILLBIRTH ,Stillbirth ,management ,psychosocial/psychology ,recurrence ,stillbirth ,subsequent pregnancy ,EXPERIENCES ,Management ,FOS: Psychology ,Female ,Medicina Critica y de Emergencia ,Worry ,Developed country ,Psychosocial ,Adult ,COUNTRIES ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,media_common.quotation_subject ,education ,Young Adult ,03 medical and health sciences ,Subsequent pregnancy ,medicine ,Humans ,Developing Countries ,EXPECTATIONS ,METAANALYSIS ,Quality of Health Care ,Internet ,Pregnancy ,Descriptive statistics ,business.industry ,Developed Countries ,618: Geburtsmedizin und Hebammenarbeit ,medicine.disease ,Psychosocial/psychology ,Family medicine ,UNEXPLAINED STILLBIRTH ,business - Abstract
OBJECTIVE: To assess the frequency of additional care, and parents' perceptions of quality, respectful care, in pregnancies subsequent to stillbirth. DESIGN: Multi-language web-based survey. SETTING: International. POPULATION: A total of 2716 parents, from 40 high- and middle-income countries. METHODS: Data were obtained from a broader survey of parents' experiences following stillbirth. Data were analysed using descriptive statistics and stratified by geographic region. Subgroup analyses explored variation in additional care by gestational age at index stillbirth. MAIN OUTCOME MEASURES: Frequency of additional care, and perceptions of quality, respectful care. RESULTS: The majority (66%) of parents conceived their subsequent pregnancy within 1 year of stillbirth. Additional antenatal care visits and ultrasound scans were provided for 67% and 70% of all parents, respectively, although there was wide variation across geographic regions. Care addressing psychosocial needs was less frequently provided, such as additional visits to a bereavement counsellor (10%) and access to named care provider's phone number (27%). Compared with parents whose stillbirth occurred at ≤ 29 weeks of gestation, parents whose stillbirth occurred at ≥ 30 weeks of gestation were more likely to receive various forms of additional care, particularly the option for early delivery after 37 weeks. Around half (47-63%) of all parents felt that elements of quality, respectful care were consistently applied, such as spending enough time with parents and involving parents in decision-making. CONCLUSIONS: Greater attention is required to providing thoughtful, empathic and collaborative care in all pregnancies following stillbirth. Specific education and training for health professionals is needed. Fil: Wojcieszek, A.M.. The University Of Queensland; Australia Fil: Boyle, F.M.. The University Of Queensland; Australia Fil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. International Stillbirth Alliance; Reino Unido. Instituto de Eficacia Clínica y Política de Salud; Argentina Fil: Cassidy, J. International Stillbirth Alliance; Reino Unido. Umamanita; España Fil: Cassidy, P. International Stillbirth Alliance; Reino Unido. Umamanita; España Fil: Erwich, J.J.H.M.. International Stillbirth Alliance; Reino Unido. University of Groningen; Países Bajos Fil: Farrales, L. International Stillbirth Alliance; Reino Unido. University of British Columbia; Canadá. Research and Support Society; Canadá Fil: Gross, MM. International Stillbirth Alliance; Reino Unido. Hannover Medical School; Alemania. Universitat Zurich; Suiza Fil: Heazell, A.E.P. International Stillbirth Alliance; Reino Unido. University of Manchester; Reino Unido. Manchester Academic Health Science Centre; Reino Unido Fil: Leisher, S.H.. International Stillbirth Alliance; Reino Unido. The University Of Queensland; Australia Fil: Mills, T. University of Manchester; Reino Unido Fil: Murphy, M. International Stillbirth Alliance; Reino Unido. University College Cork; Irlanda Fil: Pettersson, K. International Stillbirth Alliance; Reino Unido. Karolinska University; Suecia Fil: Ravaldi, C. International Stillbirth Alliance; Reino Unido. Ciao Lapo Onlus; Italia Fil: Ruidiaz, J. International Stillbirth Alliance; Reino Unido. Era en Abril; Argentina Fil: Siassakos, D. International Stillbirth Alliance; Reino Unido. University of Bristol; Reino Unido Fil: Silver, R.M.. International Stillbirth Alliance; Reino Unido. University of Utah; Estados Unidos Fil: Storey, C. International Stillbirth Alliance; Reino Unido Fil: Vannacci, A. International Stillbirth Alliance; Reino Unido. Ciao Lapo Onlus; Italia. University of Florence; Italia Fil: Middleton, P. International Stillbirth Alliance; Reino Unido. South Australian Health and Medical Research Institute; Australia Fil: Ellwood, D. International Stillbirth Alliance; Reino Unido. Griffith University and Gold Coast University ; Australia Fil: Flenady, V. International Stillbirth Alliance; Reino Unido. University of Queensland; Australia
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- 2016
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14. Making stillbirths visible: a systematic review of globally reported causes of stillbirth
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Jason Gardosi, Sanne J. Gordijn, Aleena M. Wojcieszek, Adrienne Gordon, Fleurisca J. Korteweg, Jan Jaap H. M. Erwich, Alexander E. P. Heazell, Susannah Hopkins Leisher, Katherine J. Gold, Rohan Lourie, T. Y. Khong, Z. Teoh, Karin Pettersson, Joy E Lawn, Sarah Henry, Glenn Gardener, Robert M. Silver, David Ellwood, Ö Tunçalp, Hanna E. Reinebrant, Elizabeth M. McClure, Robert Clive Pattinson, Elizabeth S Draper, Michael Coory, Dimitrios Siassakos, Emma R. Allanson, Vicki Flenady, J. F. Froen, Hannah Blencowe, Jeremy Oats, Gordon C. S. Smith, Smith, Gordon [0000-0003-2124-0997], and Apollo - University of Cambridge Repository
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medicine.medical_specialty ,PERINATAL-MORTALITY ,Global Health ,PERIOD ICD-PM ,cause of death ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,RECODE ,Maternal Health Services ,030212 general & internal medicine ,UNITED-KINGDOM ,Selection (genetic algorithm) ,reproductive and urinary physiology ,NEONATAL DEATH ,030219 obstetrics & reproductive medicine ,business.industry ,Quality assessment ,Obstetrics ,ICD ,Obstetrics and Gynecology ,Stillbirth ,SOUTH-AFRICA ,female genital diseases and pregnancy complications ,CLASSIFICATION SYSTEMS ,Pregnancy Complications ,classification ,Family medicine ,systems ,VERBAL AUTOPSY ,Female ,FETAL-GROWTH RESTRICTION ,CONSENSUS ,business - 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. FUNDING: HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). TWEETABLE ABSTRACT: Urgent need to improve data on causes of stillbirths across all settings to meet global targets. PLAIN LANGUAGE SUMMARY: Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we collected reports on the causes of stillbirth from high-, middle-, and low-income countries to: (1) Understand the causes of stillbirth, and (2) Understand how to improve reporting of stillbirths. Findings We found 85 reports from 50 different countries. The information available from the reports was inconsistent and often of poor quality, so it was hard to get a clear picture about what are the causes of stillbirth across the world. Many different definitions of stillbirth were used. There was also wide variation in what investigations of the mother and baby were undertaken to identify the cause of stillbirth. Stillbirths in all income settings (low-, middle-, and high-income countries) were most frequently reported as Unexplained, Other, and Haemorrhage (bleeding). Unexplained and Other are not helpful in understanding why a baby was stillborn. In low-income countries, stillbirths were often attributed to Infection and Complications during labour and birth. In middle- and high-income countries, stillbirths were often reported as Placental complications. Limitations We may have missed some reports as searches were carried out in English only. The available reports were of poor quality. Implications Many countries, particularly those where the majority of stillbirths occur, do not report any information about these deaths. Where there are reports, the quality is often poor. It is important to improve the investigation and reporting of stillbirth using a standardised system so that policy makers and healthcare workers can develop effective stillbirth prevention programs. All stillbirths should be investigated and reported in line with the World Health Organization standards.
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- 2017
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15. Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death:IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)
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Vicki Flenady, Adrienne Gordon, Diana M. Bond, Claire Storey, Fleurisca J. Korteweg, Alexander E. P. Heazell, Viviana Rodriguez, Kamal Kishore, Alison L. Kent, Glenn Gardener, Aleena M. Wojcieszek, Jeremy Oats, Susan Arbuckle, Robert M. Silver, Patricia A. Wilson, Paula Gardiner, Jan Jaap H. M. Erwich, David Ellwood, Susannah Hopkins Leisher, T. H. Nguyen Duc, Adrian Charles, and Reproductive Origins of Adult Health and Disease (ROAHD)
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Program evaluation ,medicine.medical_specialty ,Health Personnel ,CONSENT ,Best practice ,Neonatal death ,education ,Reproductive medicine ,Clinical practice ,Education ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Pregnancy ,Surveys and Questionnaires ,Obstetrics and Gynaecology ,Health care ,Fiji ,Humans ,Training ,Medicine ,030212 general & internal medicine ,Netherlands ,030219 obstetrics & reproductive medicine ,STILLBIRTH ,business.industry ,Perinatal mortality ,Public health ,Australia ,Infant, Newborn ,Obstetrics and Gynecology ,Guideline ,Perinatal Care ,Alliance ,Vietnam ,Practice Guidelines as Topic ,Female ,Perinatal death ,business ,Program Evaluation ,Research Article - Abstract
BACKGROUND: Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE). The programme has a major focus on stillbirth and is delivered as six interactive skills-based stations. We aimed to determine participants' pre- and post-programme knowledge of and confidence in the management of perinatal deaths, along with satisfaction with the programme. We also aimed to determine suitability for international use.METHODS: The IMPROVE programme was delivered to health professionals in maternity hospitals in all seven Australian states and territories and modified for use internationally with piloting in Vietnam, Fiji, and the Netherlands (with the assistance of the International Stillbirth Alliance, ISA). Modifications were made to programme materials in consultation with local teams and included translation for the Vietnam programme. Participants completed pre- and post-programme evaluation questionnaires on knowledge and confidence on six key components of perinatal death management as well as a satisfaction questionnaire.RESULTS: Over the period May 2012 to May 2015, 30 IMPROVE workshops were conducted, including 26 with 758 participants in Australia and four with 136 participants internationally. Evaluations showed a significant improvement between pre- and post-programme knowledge and confidence in all six stations and overall, and a high degree of satisfaction in all settings.CONCLUSIONS: The IMPROVE programme has been well received in Australia and in three different international settings and is now being made available through ISA. Future research is required to determine whether the immediate improvements in knowledge are sustained with less causes of death being classified as unknown, changes in clinical practice and improvement in parents' experiences with care. The suitability for this programme in low-income countries also needs to be established.
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- 2016
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16. Seeking order amidst chaos: a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014
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Alexander E. P. Heazell, Hanna E. Reinebrant, Fleurisca J. Korteweg, Robert Clive Pattinson, Jan Jaap H. M. Erwich, Joy E Lawn, J. Frederik Frøen, Zheyi Teoh, Ӧzge Tunçalp, Vicki Flenady, Aleena M. Wojcieszek, Susannah Hopkins Leisher, Gordon C. S. Smith, Emma R. Allanson, Jason Gardosi, Hannah Blencowe, A Metin Gülmezoglu, Elizabeth M. McClure, Sanne J. Gordijn, Smith, Gordon [0000-0003-2124-0997], and Apollo - University of Cambridge Repository
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Male ,Pediatrics ,medicine.medical_specialty ,Perinatal Death ,Neonatal death ,Reproductive medicine ,MEDLINE ,CINAHL ,PERINATAL-MORTALITY ,Cause of death ,Global Health ,03 medical and health sciences ,0302 clinical medicine ,Order (exchange) ,International Classification of Diseases ,Pregnancy ,030225 pediatrics ,Obstetrics and Gynaecology ,medicine ,Global health ,Humans ,INCOME COUNTRIES ,030219 obstetrics & reproductive medicine ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,Reproducibility of Results ,AUTOPSY ,Stillbirth ,medicine.disease ,Classification ,Systematic review ,Disparate system ,Female ,Medical emergency ,business ,Research Article ,Classification system - Abstract
Background Each year, about 5.3 million babies die in the perinatal period. Understanding of causes of death is critical for prevention, yet there is no globally acceptable classification system. Instead, many disparate systems have been developed and used. We aimed to identify all systems used or created between 2009 and 2014, with their key features, including extent of alignment with the International Classification of Diseases (ICD) and variation in features by region, to inform the World Health Organization’s development of a new global approach to classifying perinatal deaths. Methods A systematic literature review (CINAHL, EMBASE, Medline, Global Health, and PubMed) identified published and unpublished studies and national reports describing new classification systems or modifications of existing systems for causes of perinatal death, or that used or tested such systems, between 2009 and 2014. Studies reporting ICD use only were excluded. Data were independently double-extracted (except from non-English publications). Subgroup analyses explored variation by extent and region. Results Eighty-one systems were identified as new, modifications of existing systems, or having been used between 2009 and 2014, with an average of ten systems created/modified each year. Systems had widely varying characteristics: (i) comprehensiveness (40 systems classified both stillbirths and neonatal deaths); (ii) extent of use (systems were created in 28 countries and used in 40; 17 were created for national use; 27 were widely used); (iii) accessibility (three systems available in e-format); (iv) underlying cause of death (64 systems required a single cause of death); (v) reliability (10 systems tested for reliability, with overall Kappa scores ranging from .35–.93); and (vi) ICD alignment (17 systems used ICD codes). Regional databases were not searched, so system numbers may be underestimated. Some non-differential misclassification of systems was possible. Conclusions The plethora of systems in use, and continuing system development, hamper international efforts to improve understanding of causes of death. Recognition of the features of currently used systems, combined with a better understanding of the drivers of continued system creation, may help the development of a truly effective global system. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1071-0) contains supplementary material, which is available to authorized users.
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- 2016
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17. Classification systems for causes of stillbirth and neonatal death, 2009-2014: an assessment of alignment with characteristics for an effective global system
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Gordon C. S. Smith, Emma R. Allanson, Zheyi Teoh, Alexander E. P. Heazell, Jan Jaap H. M. Erwich, Hanna E. Reinebrant, A Metin Gülmezoglu, Elizabeth M. McClure, Sanne J. Gordijn, Vicki Flenady, Joy E Lawn, Susannah Hopkins Leisher, Jason Gardosi, Aleena M. Wojcieszek, Hannah Blencowe, Ӧzge Tunçalp, Fleurisca J. Korteweg, Robert Clive Pattinson, J. Frederik Frøen, Reproductive Origins of Adult Health and Disease (ROAHD), Smith, Gordon [0000-0003-2124-0997], and Apollo - University of Cambridge Repository
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Male ,NETHERLANDS ,Population ,Neonatal death ,POPULATION-BASED COHORT ,Global Health ,VALIDATION ,Unmet needs ,03 medical and health sciences ,0302 clinical medicine ,SOCIOECONOMIC INEQUALITIES ,Pregnancy ,030225 pediatrics ,Cause of Death ,Obstetrics and Gynaecology ,Global health ,Medicine ,Humans ,education ,Cause of death ,Global system ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Infant, Newborn ,INFANT-MORTALITY ,Obstetrics and Gynecology ,Stillbirth ,Classification ,Cause ,BIRTH-WEIGHT ,Infant mortality ,TANZANIA ,Low and middle income countries ,RISK-FACTORS ,CLASSIFYING PERINATAL DEATH ,Female ,Perinatal death ,AUDIT ,business ,Research Article ,Demography ,Classification system - Abstract
Background To reduce the burden of 5.3 million stillbirths and neonatal deaths annually, an understanding of causes of deaths is critical. A systematic review identified 81 systems for classification of causes of stillbirth (SB) and neonatal death (NND) between 2009 and 2014. The large number of systems hampers efforts to understand and prevent these deaths. This study aimed to assess the alignment of current classification systems with expert-identified characteristics for a globally effective classification system. Methods Eighty-one classification systems were assessed for alignment with 17 characteristics previously identified through expert consensus as necessary for an effective global system. Data were extracted independently by two authors. Systems were assessed against each characteristic and weighted and unweighted scores assigned to each. Subgroup analyses were undertaken by system use, setting, type of death included and type of characteristic. Results None of the 81 systems were aligned with more than 9 of the 17 characteristics; most (82 %) were aligned with four or fewer. On average, systems were aligned with 19 % of characteristics. The most aligned system (Frøen 2009-Codac) still had an unweighted score of only 9/17. Alignment with individual characteristics ranged from 0 to 49 %. Alignment was somewhat higher for widely used as compared to less used systems (22 % v 17 %), systems used only in high income countries as compared to only in low and middle income countries (20 % vs 16 %), and systems including both SB and NND (23 %) as compared to NND-only (15 %) and SB-only systems (13 %). Alignment was higher with characteristics assessing structure (23 %) than function (15 %). Conclusions There is an unmet need for a system exhibiting all the characteristics of a globally effective system as defined by experts in the use of systems, as none of the 81 contemporary classification systems assessed was highly aligned with these characteristics. A particular concern in terms of global effectiveness is the lack of alignment with “ease of use” among all systems, including even the most-aligned. A system which meets the needs of users would have the potential to become the first truly globally effective classification system. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1040-7) contains supplementary material, which is available to authorized users.
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- 2016
18. Characteristics of a global classification system for perinatal deaths: a Delphi consensus study
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Özge Tunçalp, Metin Gülmezoglu, Aleena M. Wojcieszek, Fleurisca J. Korteweg, Robert M. Silver, J. Frederik Frøen, Elizabeth M. McClure, Vicki Flenady, Sanne J. Gordijn, Jan Jaap H. M. Erwich, Zheyi Teoh, Alexander E. P. Heazell, Jason Gardosi, Michael Coory, Susannah Hopkins Leisher, Emma R. Allanson, Gordon C. S. Smith, Robert Clive Pattinson, Hanna E. Reinebrant, Smith, Gordon [0000-0003-2124-0997], Apollo - University of Cambridge Repository, and Reproductive Origins of Adult Health and Disease (ROAHD)
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Pediatrics ,medicine.medical_specialty ,Consensus ,Delphi Technique ,STILLBIRTHS ,COUNT ,Neonatal death ,Reproductive medicine ,Delphi method ,Global Health ,Formative assessment ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Cause of Death ,Obstetrics and Gynaecology ,medicine ,Global health ,Humans ,030212 general & internal medicine ,Causes of death ,computer.programming_language ,Cause of death ,030219 obstetrics & reproductive medicine ,business.industry ,MORTALITY ,Infant, Newborn ,Systems ,Obstetrics and Gynecology ,Stillbirth ,Classification ,Disparate system ,Family medicine ,Female ,Perinatal death ,business ,computer ,Delphi ,Research Article ,Perinatal Deaths - Abstract
${\bf Background}$ 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. ${\bf Methods}$ 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. ${\bf Results}$ 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. ${\bf Conclusion}$ 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., This project was initially undertaken as part of the Harmonized Reproductive Health Registries project through the Norwegian Institute of Public Health in Partnership with the Mater Medical Research Institute, Brisbane, Australia, and in collaboration with the Department of Reproductive Health and Research, WHO., This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by BioMed Central.
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- 2016
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19. Stillbirths: progress and unfinished business
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J Frederik Frøen, Ingrid K Friberg, Joy E Lawn, Zulfiqar A Bhutta, Robert C Pattinson, Emma R Allanson, Vicki Flenady, Elizabeth M McClure, Lynne Franco, Robert L Goldenberg, Mary V Kinney, Susannah Hopkins Leisher, Catherine Pitt, Monir Islam, Ajay Khera, Lakhbir Dhaliwal, Neelam Aggarwal, Neena Raina, Marleen Temmerman, Luc de Bernis, Hannah Blencowe, and Alexander Heazell
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Pediatrics ,medicine.medical_specialty ,Biomedical Research ,International Cooperation ,Interprofessional Relations ,Psychological intervention ,Global Health ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Pregnancy ,Prenatal Diagnosis ,Preventive Health Services ,Global health ,Medicine ,Humans ,030212 general & internal medicine ,Health policy ,Medicine(all) ,030219 obstetrics & reproductive medicine ,business.industry ,Health Priorities ,Health Policy ,Global strategy ,General Medicine ,Stillbirth ,Health indicator ,Call to action ,Early Diagnosis ,Healthy People Programs ,Action plan ,Mandate ,Female ,business - Abstract
This first paper of the Lancet Series on ending preventable stillbirths reviews progress in essential areas, identified in the 2011 call to action for stillbirth prevention, to inform the integrated post-2015 agenda for maternal and newborn health. Worldwide attention to babies who die in stillbirth is rapidly increasing, from integration within the new Global Strategy for Women's, Children's and Adolescents' Health, to country policies inspired by the Every Newborn Action Plan. Supportive new guidance and metrics including stillbirth as a core health indicator and measure of quality of care are emerging. Prenatal health is a crucial biological foundation to life-long health. A key priority is to integrate action for prenatal health within the continuum of care for maternal and newborn health. Still, specific actions for stillbirths are needed for advocacy, policy formulation, monitoring, and research, including improvement in the dearth of data for effective coverage of proven interventions for prenatal survival. Strong leadership is needed worldwide and in countries. Institutions with a mandate to lead global efforts for mothers and their babies must assert their leadership to reduce stillbirths by promoting healthy and safe pregnancies.
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- 2016
20. Stillbirths: economic and psychosocial consequences
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Alexander E P Heazell, Dimitrios Siassakos, Hannah Blencowe, Christy Burden, Zulfiqar A Bhutta, Joanne Cacciatore, Nghia Dang, Jai Das, Vicki Flenady, Katherine J Gold, Olivia K Mensah, Joseph Millum, Daniel Nuzum, Keelin O'Donoghue, Maggie Redshaw, Arjumand Rizvi, Tracy Roberts, H E Toyin Saraki, Claire Storey, Aleena M Wojcieszek, Soo Downe, J Frederik Frøen, Mary V Kinney, Luc de Bernis, Joy E Lawn, Susannah Hopkins Leisher, Ingela Radestad, Louise Jackson, Chidubem Ogwulu, Alison Hills, Stephanie Bradley, Wendy Taylor, and Jayne Budd
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Parents ,medicine.medical_specialty ,media_common.quotation_subject ,Health Personnel ,A990 ,Prenatal care ,Social Security ,03 medical and health sciences ,Indirect costs ,Social support ,Health Economics ,0302 clinical medicine ,Pregnancy ,Environmental health ,Health care ,medicine ,Financial Support ,Humans ,030212 general & internal medicine ,Psychiatry ,reproductive and urinary physiology ,media_common ,Family Health ,Stereotyping ,030219 obstetrics & reproductive medicine ,Health economics ,business.industry ,Social Support ,Prenatal Care ,General Medicine ,Health Care Costs ,Stillbirth ,Mental health ,Intangible costs ,Systematic review ,Costs and Cost Analysis ,Income ,Grief ,Female ,Quality-Adjusted Life Years ,Health Expenditures ,business ,Psychosocial ,Stress, Psychological - Abstract
Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.
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- 2016
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21. Stillbirths: ending preventable deaths by 2030
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Luc de Bernis, Donna Vivio, Lori McDougall, Joy E Lawn, Address Malata, William Stones, Zulfiqar A Bhutta, Metin Gülmezoglu, Mary V Kinney, Susannah Hopkins Leisher, Jennifer Zeitlin, Kim E Dickson, Matthews Mathai, José M. Belizán, Petra ten Hoope-Bender, Lynne Franco, University of St Andrews. School of Medicine, and University of St Andrews. Global Health Implementation Group
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Program evaluation ,Culture ,Psychological intervention ,Medicina Clínica ,Global Health ,B720 ,Health informatics ,Health Services Accessibility ,0302 clinical medicine ,Cost of Illness ,Pregnancy ,Preventive Health Services ,purl.org/becyt/ford/3.2 [https] ,Global health ,Medicine ,030212 general & internal medicine ,reproductive and urinary physiology ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Mortality rate ,Prenatal Care ,General Medicine ,Stillbirth ,female genital diseases and pregnancy complications ,RG Gynecology and obstetrics ,Female ,purl.org/becyt/ford/3 [https] ,Medicina Critica y de Emergencia ,CIENCIAS MÉDICAS Y DE LA SALUD ,Interprofessional Relations ,Population ,NDAS ,Prenatal care ,03 medical and health sciences ,stilbirths ,Nursing ,SDG 3 - Good Health and Well-being ,Survivorship curve ,Environmental health ,Humans ,Newborn health ,education ,Quality of Health Care ,Stereotyping ,Health Priorities ,business.industry ,Prevention ,Social Support ,Prenatal health ,Maternal health ,Health Expenditures ,RG ,business - Abstract
Efforts to achieve the new worldwide goals for maternal and child survival will also prevent stillbirth and improve health and developmental outcomes. However, the number of annual stillbirths remains unchanged since 2011 and is unacceptably high: an estimated 2·6 million in 2015. Failure to consistently include global targets or indicators for stillbirth in post-2015 initiatives shows that stillbirths are hidden in the worldwide agenda. This Series paper summarises findings from previous papers in this Series, presents new analyses, and proposes specific criteria for successful integration of stillbirths into post-2015 initiatives for women's and children's health. Five priority areas to change the stillbirth trend include intentional leadership; increased voice, especially of women; implementation of integrated interventions with commensurate investment; indicators to measure effect of interventions and especially to monitor progress; and investigation into crucial knowledge gaps. The post-2015 agenda represents opportunities for all stakeholders to act together to end all preventable deaths, including stillbirths. Fil: de Bernis, Luc. UN Population Fund; Suiza Fil: Kinney, Mary V.. Save the Children; Sudáfrica Fil: Stones, William. University of St. Andrews; Reino Unido. University of Malawi; Malaui. International Federation of Gynecology and Obstetrics; Reino Unido Fil: ten Hoope-Bender, Petra. Independent Consultant; Suiza Fil: Vivio, Donna. Agency for International Development; Estados Unidos Fil: Hopkins Leisher, Susannah. International Stillbirth Alliance; Estados Unidos. University of Queensland; Australia Fil: Bhutta, Zulfiqar A.. The Hospital for Sick Children; Canadá. The Aga Khan University, Karachi; Pakistán. World Health Organization; Suiza Fil: Gülmezoglu, Metin. World Health Organization; Suiza Fil: Mathai, Matthews. World Health Organization; Suiza Fil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Franco, Lynne. EnCompass LLC; Estados Unidos Fil: McDougall, Lori. Newborn and Child Health; Suiza Fil: Zeitlin, Jennifer. Paris Descartes University; Francia Fil: Malata, Address. Kamuzu College of Nursing University of Malawi; Malaui Fil: Dickson, Kim E.. UNICEF; Estados Unidos Fil: Lawn, Joy E.. London School of Hygiene & Tropical Medicine; Reino Unido. Save the Children; Estados Unidos
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- 2016
22. Stillbirths: Recall to action in high-income countries
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Vicki Flenady, Aleena M Wojcieszek, Philippa Middleton, David Ellwood, Jan Jaap Erwich, Michael Coory, T Yee Khong, Robert M Silver, Gordon C S Smith, Frances M Boyle, Joy E Lawn, Hannah Blencowe, Susannah Hopkins Leisher, Mechthild M Gross, Dell Horey, Lynn Farrales, Frank Bloomfield, Lesley McCowan, Stephanie J Brown, K S Joseph, Jennifer Zeitlin, Hanna E Reinebrant, Joanne Cacciatore, Claudia Ravaldi, Alfredo Vannacci, Jillian Cassidy, Paul Cassidy, Cindy Farquhar, Euan Wallace, Dimitrios Siassakos, Alexander E P Heazell, Claire Storey, Lynn Sadler, Scott Petersen, J Frederik Frøen, Robert L Goldenberg, Mary V Kinney, Luc de Bernis, Alexander Heazell, Jessica Ruidiaz, Andre Carvalho, Jane Dahlstrom, Christine East, Jane P Fox, Kristen Gibbons, Ibinabo Ibiebele, Sue Kildea, Glenn Gardener, Rohan Lourie, Patricia Wilson, Adrienne Gordon, Belinda Jennings, Alison Kent, Susan McDonald, Kelly Merchant, Jeremy Oats, Susan P Walker, Leanne Raven, Anne Schirmann, Francine de Montigny, Grace Guyon, Beatrice Blondel, Sabine de Wall, Sheelagh Bonham, Paul Corcoran, Mairie Cregan, Sarah Meany, Margaret Murphy, Stephanie Fukui, Sanne Gordijn, Fleurisca Korteweg, Robin Cronin, Vicki Mason, Vicki Culling, Anna Usynina, Karin Pettersson, Ingela Rådestad, Susanne van Gogh, Bia Bichara, Stephanie Bradley, Alison Ellis, Soo Downe, Elizabeth Draper, Brad Manktelow, Janet Scott, Lucy Smith, William Stones, Tina Lavender, Wes Duke, Ruth C Fretts, Katherine J Gold, Elizabeth McClure, Uma Reddy, and Reproductive Origins of Adult Health and Disease (ROAHD)
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International Cooperation ,LATE-PREGNANCY STILLBIRTH ,ANTENATAL CARE ,Global Health ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Global health ,Medicine ,030212 general & internal medicine ,reproductive and urinary physiology ,Perinatal mortality ,RISK ,030219 obstetrics & reproductive medicine ,Obstetrics ,Health Policy ,Medicine (all) ,Prenatal Care ,General Medicine ,High-income countries ,Stillbirth ,Classification ,Health equity ,female genital diseases and pregnancy complications ,Data Accuracy ,Practice Guidelines as Topic ,Income ,Female ,Developed country ,Attitude to Health ,WOMENS EXPERIENCES ,Postnatal Care ,medicine.medical_specialty ,UNITED-STATES ,Gestational Age ,Prenatal care ,03 medical and health sciences ,Bereavement care ,Environmental health ,Humans ,Healthcare Disparities ,Socioeconomic status ,Health policy ,Perinatal Mortality ,Late Stillbirth ,Stereotyping ,business.industry ,Developed Countries ,Quality of care ,HEALTH DISPARITIES ,INFANT-MORTALITY ,618: Geburtsmedizin und Hebammenarbeit ,Infant mortality ,EARLY-TERM BIRTH ,Hospice Care ,PRENATAL-CARE ,Implementation ,business ,Perinatal audit ,FETAL-GROWTH RESTRICTION ,Delivery of Health Care - Abstract
Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation ( 28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.
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23. Stillbirths : Rates, risk factors, and acceleration towards 2030
- Author
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Joy E Lawn, Hannah Blencowe, Peter Waiswa, Agbessi Amouzou, Colin Mathers, Dan Hogan, Vicki Flenady, J Frederik Frøen, Zeshan U Qureshi, Claire Calderwood, Suhail Shiekh, Fiorella Bianchi Jassir, Danzhen You, Elizabeth M McClure, Matthews Mathai, Simon Cousens, Mary V Kinney, Luc de Bernis, Alexander Heazell, Susannah Hopkins Leisher, Kishwar Azad, Anisur Rahman, Shams El-Arifeen, Louise T Day, Stacy L Shah, Shafi Alam, Sonam Wangdi, Tinga Fulbert Ilboudo, Jun Zhu, Juan Liang, Yi Mu, Xiaohong Li, Nanbert Zhong, Theopisti Kyprianou, Kärt Allvee, Mika Gissler, Jennifer Zeitlin, Abdouli Bah, Lamin Jawara, Nicholas Lack, Flor de Maria Herandez, Neena Shah More, Nirmala Nair, Prasanta Tripathy, Rajesh Kumar, Ariarathinam Newtonraj, Manmeet Kaur, Madhu Gupta, Beena Varghese, Jelena Isakova, Tambosi Phiri, Jennifer A Hall, Ala Curteanu, Dharma Manandhar, Chantal Hukkelhoven, Joyce Dijs-Elsinga, Kari Klungsøyr, Olva Poppe, Henrique Barros, Sofi Correia, Shorena Tsiklauri, Jan Cap, Zuzana Podmanicka, Katarzyna Szamotulska, Robert Pattison, Ahmed Ali Hassan, Aimable Musafi, Sanni Kujala, Anna Bergstrom, Jens Langhoff -Roos, Ellen Lundqvist, Daniel Kadobera, Anthony Costello, Tim Colbourn, Edward Fottrell, Audrey Prost, David Osrin, Carina King, Melissa Neuman, Jane Hirst, Sayed Rubayet, Lucy Smith, Bradley N Manktelow, and Elizabeth S Draper
- Subjects
Pediatrics ,medicine.medical_specialty ,Population ,Developing country ,Prenatal care ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Global health ,Life Science ,030212 general & internal medicine ,education ,reproductive and urinary physiology ,Medicine(all) ,education.field_of_study ,Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,Attributable risk ,Syphilis ,business ,Developed country ,Demography - Abstract
An estimated 2·6 million third trimester stillbirths occurred in 2015 (uncertainty range 2·4-3·0 million). The number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the Millennium Development Goals. The Every Newborn Action Plan has the target of 12 or fewer stillbirths per 1000 births in every country by 2030. 94 mainly high-income countries and upper middle-income countries have already met this target, although with noticeable disparities. At least 56 countries, particularly in Africa and in areas aff ected by confl ict, will have to more than double present progress to reach this target. Most (98%) stillbirths are in low-income and middle-income countries. Improved care at birth is essential to prevent 1·3 million (uncertainty range 1·2-1·6 million) intrapartum stillbirths, end preventable maternal and neonatal deaths, and improve child development. Estimates for stillbirth causation are impeded by various classifi cation systems, but for 18 countries with reliable data, congenital abnormalities account for a median of only 7·4% of stillbirths. Many disorders associated with stillbirths are potentially modifi able and often coexist, such as maternal infections (population attributable fraction: malaria 8·0% and syphilis 7·7%), non-communicable diseases, nutrition and lifestyle factors (each about 10%), and maternal age older than 35 years (6·7%). Prolonged pregnancies contribute to 14·0% of stillbirths. Causal pathways for stillbirth frequently involve impaired placental function, either with fetal growth restriction or preterm labour, or both. Two-thirds of newborns have their births registered. However, less than 5% of neonatal deaths and even fewer stillbirths have death registration. Records and registrations of all births, stillbirths, neonatal, and maternal deaths in a health facility would substantially increase data availability. Improved data alone will not save lives but provide a way to target interventions to reach more than 7000 women every day worldwide who experience the reality of stillbirth.
- Published
- 2016
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