Dataset Information

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

ABSTRACT:

Objective

We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm.

Design

Prospective, observational study.

Setting

Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya.

Population

Pregnant women residing in defined study regions.

Methods

Basic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hierarchal algorithm assigned cause of stillbirth. Causes included birth trauma, congenital anomaly, infection, asphyxia, and preterm birth, based on existing cause of death classifications and included contributing maternal conditions.

Main outcome measures

Primary cause of stillbirth.

Results

Of 109 911 women who were enrolled and delivered (99% of those screened in pregnancy), 2847 had a stillbirth (a rate of 27.2 per 1000 births). Asphyxia was the cause of 46.6% of the stillbirths, followed by infection (20.8%), congenital anomalies (8.4%) and prematurity (6.6%). Among those caused by asphyxia, 38% had prolonged or obstructed labour, 19% antepartum haemorrhage and 18% pre-eclampsia/eclampsia. About two-thirds (67.4%) of the stillbirths did not have signs of maceration.

Conclusions

Our algorithm determined cause of stillbirth from basic data obtained from lay-health providers. The major cause of stillbirth was fetal asphyxia associated with prolonged or obstructed labour, pre-eclampsia and antepartum haemorrhage. In the African sites, infection also was an important contributor to stillbirth. Using this algorithm, we documented cause of stillbirth and its trends to inform public health programs, using consistency, transparency, and comparability across time or regions with minimal burden on the healthcare system.

Tweetable abstract

Major causes of stillbirth are asphyxia, pre-eclampsia and haemorrhage. Infections are important in Africa.

SUBMITTER: McClure EM

PROVIDER: S-EPMC5537043 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

McClure E M EM Garces A A Saleem S S Moore J L JL Bose C L CL Esamai F F Goudar S S SS Chomba E E Mwenechanya M M Pasha O O Tshefu A A Patel A A Dhaded S M SM Tenge C C Marete I I Bauserman M M Sunder S S Kodkany B S BS Carlo W A WA Derman R J RJ Hibberd P L PL Liechty E A EA Hambidge K M KM Krebs N F NF Koso-Thomas M M Miodovnik M M Wallace D D DD Goldenberg R L RL

BJOG : an international journal of obstetrics and gynaecology 20170131 2

<h4>Objective</h4>We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm.<h4>Design</h4>Prospective, observational study.<h4>Setting</h4>Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya.<h4>Population</h4>Pregnant women residing in defined study regions.<h4>Methods</h4>Basic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hier ...[more]

PMID: 28139875

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Dataset Information

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusions

Tweetable abstract

Publications

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

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