Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Autor: Lachmi R. Kodan, Zita D. Prüst, Kitty W. M. Bloemenkamp, Gieta A. A. Bhikha-Kori, Marcus J. Rijken, Joyce L. Browne, Kim J. C. Verschueren
Přispěvatelé: Obstetrics and Gynaecology
Rok vydání: 2020
Předmět:
Adult
Latin Americans
Perinatal Death
World Health Organization
Middle income country
World health
03 medical and health sciences
0302 clinical medicine
International Classification of Diseases
Pregnancy
Risk Factors
Cause of Death
Environmental health
Foetal death
Humans
Medicine
National level
030212 general & internal medicine
reproductive and urinary physiology
Suriname
Perinatal mortality
business.industry
030503 health policy & services
Health Policy
Infant
Newborn
Parturition
Public Health
Environmental and Occupational Health
Stillbirth
Hospitals
female genital diseases and pregnancy complications
ICD-PM
Cross-Sectional Studies
middle-income country
Caribbean Region
classification
perinatal mortality
Original Article
Female
Public aspects of medicine
RA1-1270
0305 other medical science
business
Stillbirths
foetal death
Research Article
Perinatal Deaths
Zdroj: Global health action, 13(1):1794105. Taylor and Francis Ltd.
Global Health Action, Vol 13, Iss 1 (2020)
Global Health Action
article-version (VoR) Version of Record
ISSN: 1654-9880
1654-9716
DOI: 10.1080/16549716.2020.1794105
Popis: Background Suriname has one of the highest stillbirth rates in Latin America and the Caribbean. To facilitate data comparison of perinatal deaths, the World Health Organization developed the International Classification of Diseases-10 Perinatal Mortality (ICD-PM). Objective We aimed to (1) assess characteristics and risk indicators of women with a stillbirth, (2) determine the timing and causes of stillbirths according to the ICD-PM with critical evaluation of its application and (3) propose recommendations for the reduction of stillbirths in Suriname. Methods A hospital-based, nation-wide, cross-sectional study was conducted in all hospitals within Suriname during one-year (2017). The medical files of stillbirths (gestation ≥28 weeks/birth weight ≥1000 grams) were reviewed and classified using ICD-PM. We used descriptive statistics and multiple logistic regression analyses. Results The stillbirth rate in Suriname was 14.4/1000 births (n=131 stillbirths, n=9089 total births). Medical files were available for 86% (n=113/131) of stillbirths. Women of African descent had the highest stillbirth rate and two times the odds of stillbirth (OR 2.1, 95%CI 1.4–3.1) compared to women of other ethnicities. One third (33%, n=37/113) of stillbirths occurred after hospital admission. The timing was antepartum in 85% (n=96/113), intrapartum in 11% (n=12/113) and unknown in 4% (n=5/113). Antepartum stillbirths were caused by hypoxia in 46% (n=44/96). In 41% (n=39/96) the cause was unspecified. Maternal medical and surgical conditions were present in 50% (n=57/113), mostly hypertensive disorders. Conclusion Stillbirth reduction strategies in Suriname call for targeting ethnic disparities, improving antenatal services, implementing perinatal death audits and improving diagnostic post-mortem investigations. ICD-PM limited the formulation of recommendations due to many stillbirths of ‘unspecified’ causes. Based on our study findings, we also recommend addressing some challenges with applying the ICD-PM. Abbreviations CTG: Cardiotocography; ENAP: Every Newborn Action Plan (ENAP); ICD-PM: The WHO application of ICD-10 to deaths during the perinatal period – perinatal mortality; SBR: Stillbirth rate; SGA: Small for gestational age; WHO: World Health Organization; LMIC: Low- and middle-income countries; FHR: foetal heart rate.
Databáze: OpenAIRE
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