학술논문

Making stillbirths count, making numbers talk - Issues in data collection for stillbirths
Debate
Document Type
Clinical report
Source
BMC Pregnancy and Childbirth. December 17, 2009, Vol. 9, 58
Subject
World Health Organization
Statistics
Demographic aspects
Infant mortality -- Statistics -- Demographic aspects
Public health -- Statistics
Stillbirth -- Statistics -- Demographic aspects
Medical care quality -- Statistics
Infants -- Patient outcomes
Still-birth -- Statistics -- Demographic aspects
Medical care -- Quality management
Language
English
Abstract
Authors: J Frederik Frøen (corresponding author) [1]; Sanne J Gordijn [2]; Hany Abdel-Aleem [3]; Per Bergsjø [4]; Ana Betran [5]; Charles W Duke [6]; Vincent Fauveau [7]; Vicki Flenady [8,9]; [...]
Background Stillbirths need to count. They constitute the majority of the world's perinatal deaths and yet, they are largely invisible. Simply counting stillbirths is only the first step in analysis and prevention. From a public health perspective, there is a need for information on timing and circumstances of death, associated conditions and underlying causes, and availability and quality of care. This information will guide efforts to prevent stillbirths and improve quality of care. Discussion In this report, we assess how different definitions and limits in registration affect data capture, and we discuss the specific challenges of stillbirth registration, with emphasis on implementation. We identify what data need to be captured, we suggest a dataset to cover core needs in registration and analysis of the different categories of stillbirths with causes and quality indicators, and we illustrate the experience in stillbirth registration from different cultural settings. Finally, we point out gaps that need attention in the International Classification of Diseases and review the qualities of alternative systems that have been tested in low- and middle-income settings. Summary Obtaining high-quality data will require consistent definitions for stillbirths, systematic population-based registration, better tools for surveys and verbal autopsies, capacity building and training in procedures to identify causes of death, locally adapted quality indicators, improved classification systems, and effective registration and reporting systems.