Stillbirth classification in population-based data and role of fetal growth restriction: the example of RECODE

BMC Pregnancy and Childbirth

Christine Cans¹  Thierry Debillon²  Pierre-Simon Jouk²  Marion Baran-Marszak²  Anne Fondeur²  Séverine Cornec²  Pierre Batailler²  Jennifer Zeitlin³  Anne Ego⁴ 

[1] The THEMAS, UJF-Grenoble 1, Grenoble, France;The RHEOP (Registre des Handicaps de l’Enfant et Observatoire Périnatal Isère, Savoie et Haute-Savoie), Grenoble, France;INSERM, UMR S953, Epidemiological Research on Perinatal Health and Women's and Children's Health, Paris, France;DMIS, Pavillon Taillefer, CHU Grenoble, CS 10217, 38043 Grenoble Cedex 9, France

关键词: Fetal growth;    Small for gestational age;    Associated conditions;    Cause of death;    Classification;    Stillbirths;   

Others  :  1137869
DOI  :  10.1186/1471-2393-13-182

 received in 2013-05-15, accepted in 2013-09-26,  发布年份 2013

【 摘 要 】

Background

Stillbirth classifications use various strategies to synthesise information associated with fetal demise with the aim of identifying key causes for the death. RECODE is a hierarchical classification of death-related conditions, which grants a major place to fetal growth restriction (FGR). Our objective was to explore how placement of FGR in the hierarchy affected results from the classification.

Methods

In the Rhône-Alpes region, all stillbirths were recorded in a local registry from 2000 to 2010 in three districts (N = 969). Small for gestational age (SGA) was defined as a birthweight below the 10^th percentile. We applied RECODE and then modified the hierarchy, including FGR as the penultimate category (RECODE-R).

Results

49.0% of stillbirths were SGA. From RECODE to RECODE-R, stillbirths attributable to FGR decreased from 38% to 14%, in favour of other related conditions. Nearly half of SGA stillbirths (49%) were reclassified. There was a non-significant tendency toward moderate SGA, singletons and full-term stillbirths to older mothers being reclassified.

Conclusions

The position of FGR in hierarchical stillbirth classification has a major impact on the first condition associated with stillbirth. RECODE-R calls less attention to monitoring SGA fetuses but illustrates the diversity of death-related conditions for small fetuses.

【 授权许可】

   
2013 Ego et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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