Alison L Kent1, Jane E Dahlstrom, David Ellwood, Maureen Bourne. 1. Department of Neonatology, The Canberra Hospital, Australian National University Medical School, PO Box 11, Woden, ACT 2606, Australia. alison.kent@act.gov.au
Abstract
BACKGROUND: Because of differences in reporting criteria throughout the world, comparing perinatal mortality rates and identifying areas of concern can be complicated and imprecise. AIMS: To detail the systematic approach to reporting perinatal deaths and to identify any significant differences in outcomes in the Australian Capital Territory (ACT). METHODS: Review of perinatal deaths from 2001 to 2005 in the ACT using the Australian and New Zealand Antecedent Classification of Perinatal Mortality (ANZACPM) and the Australian and New Zealand Neonatal Death Classification (ANZNDC) systems. RESULTS: ACT residents' perinatal mortality rate was 10.6 per 1000 total births, fetal death rate 7.5 per 1000 total births and neonatal death rate 3.2 per 1000 live births. The three leading antecedent causes of perinatal death were congenital anomalies, spontaneous preterm birth and unexplained antepartum death. The three leading causes of neonatal death were extreme prematurity, cardiorespiratory disorders and congenital anomalies. Multiple births attributed to 20% (65 of 321) of perinatal deaths. Perinatal autopsy was performed in 50% of cases, but in only 64% of unexplained antepartum deaths. CONCLUSIONS: Causes of perinatal death for the ACT and surrounding New South Wales region are similar to other states using this classification system. The following are considered important lessons to promote accurate perinatal mortality reporting: (i) a universal reporting system for Australia utilising a multidisciplinary team; (ii) a high perinatal autopsy rate, especially in the critical area of antepartum death with no identifiable cause; and (iii) standardised definitions for avoidability. Attention to these areas may prompt further research and changes in practice to further reduce perinatal mortality.
BACKGROUND: Because of differences in reporting criteria throughout the world, comparing perinatal mortality rates and identifying areas of concern can be complicated and imprecise. AIMS: To detail the systematic approach to reporting perinatal deaths and to identify any significant differences in outcomes in the Australian Capital Territory (ACT). METHODS: Review of perinatal deaths from 2001 to 2005 in the ACT using the Australian and New Zealand Antecedent Classification of Perinatal Mortality (ANZACPM) and the Australian and New Zealand Neonatal Death Classification (ANZNDC) systems. RESULTS: ACT residents' perinatal mortality rate was 10.6 per 1000 total births, fetal death rate 7.5 per 1000 total births and neonatal death rate 3.2 per 1000 live births. The three leading antecedent causes of perinatal death were congenital anomalies, spontaneous preterm birth and unexplained antepartum death. The three leading causes of neonatal death were extreme prematurity, cardiorespiratory disorders and congenital anomalies. Multiple births attributed to 20% (65 of 321) of perinatal deaths. Perinatal autopsy was performed in 50% of cases, but in only 64% of unexplained antepartum deaths. CONCLUSIONS: Causes of perinatal death for the ACT and surrounding New South Wales region are similar to other states using this classification system. The following are considered important lessons to promote accurate perinatal mortality reporting: (i) a universal reporting system for Australia utilising a multidisciplinary team; (ii) a high perinatal autopsy rate, especially in the critical area of antepartum death with no identifiable cause; and (iii) standardised definitions for avoidability. Attention to these areas may prompt further research and changes in practice to further reduce perinatal mortality.
Authors: Ana L Garces; Elizabeth M McClure; Wilton Pérez; K Michael Hambidge; Nancy F Krebs; Lester Figueroa; Carl L Bose; Waldemar A Carlo; Constance Tenge; Fabian Esamai; Shivaprasad S Goudar; Sarah Saleem; Archana B Patel; Melody Chiwila; Elwyn Chomba; Antoinette Tshefu; Richard J Derman; Patricia L Hibberd; Sherri Bucher; Edward A Liechty; Melissa Bauserman; Janet L Moore; Marion Koso-Thomas; Menachem Miodovnik; Robert L Goldenberg Journal: Acta Paediatr Date: 2017-04-05 Impact factor: 2.299
Authors: Elizabeth M McClure; Carl L Bose; Ana Garces; Fabian Esamai; Shivaprasad S Goudar; Archana Patel; Elwyn Chomba; Omrana Pasha; Antoinette Tshefu; Bhalchandra S Kodkany; Sarah Saleem; Waldemar A Carlo; Richard J Derman; Patricia L Hibberd; Edward A Liechty; K Michael Hambidge; Nancy F Krebs; Melissa Bauserman; Marion Koso-Thomas; Janet Moore; Dennis D Wallace; Alan H Jobe; Robert L Goldenberg Journal: Matern Health Neonatol Perinatol Date: 2015-05-04