Theonia K Boyd1, Colleen Anne Wright2, Hein Odendaal3, Amy J Elliott4, Mary Ann Sens5, Rebecca Dunn Folkerth6, Drucilla J Roberts7, Hannah Kinney8. 1. 1 Boston Children's Hospital Department of Pathology. 2. 2 Stellenbosch University,NHLS Port Elizabeth Anatomical Pathology. 3. 3 Stellenbosch University Obstetrics and Gynecology. 4. 4 Center for Health Outcomes & Prevention, University of South Dakota School of Medicine Department of Pediatrics and Ob-Gyn. 5. 5 University North Dakota. 6. 6 Brigham and Women's Hospital Pathology. 7. 7 Massachusetts General Hospital Department of Pathology. 8. 8 Children's Hospital Boston and Harvard Medical School Pathology.
Abstract
OBJECTIVE: Describe the classification system for assigning the cause of stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD-funded Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network. The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. METHODS: The PASS Network classification system is based upon 5 'sites of origin' for cause of stillbirth, further subdivided into mechanism subcategories; both are employed to assign an ultimate cause of death. Each PASS stillbirth was assigned a cause of death, and status of sporadic versus recurrent. Adjudication involved review of maternal and obstetrical records; fetal autopsy and placental findings; and required complete consensus in each case. Two published classification systems, i.e., INCODE and ReCoDe, were used for comparison. RESULTS: Causes of stillbirth classified were: fetal (26%), placental (53%), external (5%), and undetermined (16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was full agreement for cause of death across the three classification systems in 26% of cases, and partial agreement among them in 42% of cases. CONCLUSIONS: The proposed PASS schema employs a user-friendly classification that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability to perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations.
OBJECTIVE: Describe the classification system for assigning the cause of stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD-funded Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network. The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. METHODS: The PASS Network classification system is based upon 5 'sites of origin' for cause of stillbirth, further subdivided into mechanism subcategories; both are employed to assign an ultimate cause of death. Each PASS stillbirth was assigned a cause of death, and status of sporadic versus recurrent. Adjudication involved review of maternal and obstetrical records; fetal autopsy and placental findings; and required complete consensus in each case. Two published classification systems, i.e., INCODE and ReCoDe, were used for comparison. RESULTS: Causes of stillbirth classified were: fetal (26%), placental (53%), external (5%), and undetermined (16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was full agreement for cause of death across the three classification systems in 26% of cases, and partial agreement among them in 42% of cases. CONCLUSIONS: The proposed PASS schema employs a user-friendly classification that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability to perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations.
Authors: Joshua Cornman-Homonoff; Devon Kuehn; Sofía Aros; Tonia C Carter; Mary R Conley; James Troendle; Fernando Cassorla; James L Mills Journal: J Matern Fetal Neonatal Med Date: 2011-07-05
Authors: Kimberly A Dukes; Larry Burd; Amy J Elliott; William P Fifer; Rebecca D Folkerth; Gary D V Hankins; Dale Hereld; Howard J Hoffman; Michael M Myers; Hein J Odendaal; Caroline Signore; Lisa M Sullivan; Marian Willinger; Colleen Wright; Hannah C Kinney Journal: Paediatr Perinat Epidemiol Date: 2014-08-05 Impact factor: 3.980
Authors: Donald J Dudley; Robert Goldenberg; Deborah Conway; Robert M Silver; George R Saade; Michael W Varner; Halit Pinar; Donald Coustan; Radek Bukowski; Barbara Stoll; Matthew A Koch; Corette B Parker; Uma M Reddy Journal: Obstet Gynecol Date: 2010-08 Impact factor: 7.661