1. Making stillbirths visible: a systematic review of globally reported causes of stillbirth
- Author
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Reinebrant, HE, Leisher, SH, Coory, M, Henry, S, Wojcieszek, AM, Gardener, G, Lourie, R, Ellwood, D, Teoh, Z, Allanson, E, Blencowe, H, Draper, ES, Erwich, JJ, Froen, JF, Gardosi, J, Gold, K, Gordijn, S, Gordon, A, Heazell, AEP, Khong, TY, Korteweg, F, Lawn, JE, McClure, EM, Oats, J, Pattinson, R, Pettersson, K, Siassakos, D, Silver, RM, Smith, GCS, Tuncalp, OE, Flenady, V, Reinebrant, HE, Leisher, SH, Coory, M, Henry, S, Wojcieszek, AM, Gardener, G, Lourie, R, Ellwood, D, Teoh, Z, Allanson, E, Blencowe, H, Draper, ES, Erwich, JJ, Froen, JF, Gardosi, J, Gold, K, Gordijn, S, Gordon, A, Heazell, AEP, Khong, TY, Korteweg, F, Lawn, JE, McClure, EM, Oats, J, Pattinson, R, Pettersson, K, Siassakos, D, Silver, RM, Smith, GCS, Tuncalp, OE, and Flenady, V
- 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 parent
- Published
- 2018