Assessment of risk of perinatal death in Jamaica.
Data from the Jamaican Perinatal Mortality Survey had been used to create a statistical model using logistic regression. From this a simple additive scoring system to predict perinatal death was devised and tested on the 2 cohort months of the study. The score had a theoretical range of 0-28 points, with the higher the score, the greater the likelihood of a perinatal death. For a cut-point of 7, sensitivity was 43% and specificity 84%. A cut-point of 8 resulted in 27% sensitivity and 94% specificity. Higher cut-points resulted in much reduced sensitivity but enhanced specificity (e.g. cut-point 10: 11% sensitivity, 99% specificity). However, it is likely that these estimates are optimistically high, and to achieve unbiased estimates of sensitivity and specificity the score needs to be tested on a sample of the population from which it was not derived before implementation takes place. Meanwhile, the cut-off level for implementation will depend on appropriate resources available.
Greenwood
R
R
Institute of Child Health, Bristol, UK.
Ashley
D
D
D015331:Cohort Studies; D005260:Female; D005313:Fetal Death; D005544:Forecasting; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007563:Jamaica / Q000453:epidemiology; D008880:Midwifery; D015233:Models, Statistical; D009035:Mothers / Q000145:classification; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors