AI Article Synopsis
- The study evaluated the trend of stillbirths from 2009 to 2018, using the International Classification of Diseases - Perinatal Mortality (ICD-PM) to classify causes.
- The stillbirth rate remained stable at 3.70 per 1000 total births over the examined years, with the majority (97.8%) occurring before labor.
- The use of ICD-PM significantly reduced unexplained stillbirths from 57% to 18.5% by clarifying causes, but there are challenges with certain coding categories that need improvement.
Article Abstract
Objectives: This study aimed to evaluate the trend of stillbirth from 2009 to 2018. The causes of stillbirth were classified using the International Classification of Diseases - Perinatal Mortality (ICD-PM).
Study Design And Methods: A retrospective chart review was performed on 135 stillbirths from 2009 to 2018 in a tertiary university teaching hospital. The annual stillbirth rate was calculated, and the trend was evaluated. The cause of death was reclassified using ICD-PM.
Results: The stillbirth rate was 3.70 per 1000 total births, and it remained stable over the studied period (P = 0.238). Most of the stillbirth (97.8%) were antepartum deaths. The proportion of unexplained stillbirth was reduced from 57% to 18.5% after reclassified by ICD-PM coding. Another major cause of antepartum stillbirths was disorders related to fetal growth, which consisted of mothers with medical and surgical conditions (11%, n = 15, ICD-PM code A5, M4) or mothers with complications of placenta, cord and membranes (8.9%, n = 12, ICD-PM code A5, M1).
Conclusion: The use of ICD-PM was useful in reducing the proportion of unexplained stillbirths. ICD-PM has the advantages of coding related to the timing of stillbirth and associated maternal conditions. Pitfalls including the unclear use of the code A3-'antepartum hypoxia,' guidance on coding of well-controlled maternal medical conditions and placental pathology and the importance of subcategorisation need to be addressed.
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| http://dx.doi.org/10.1016/j.puhe.2021.09.032 | DOI Listing |
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