title: A new system for determining the causes of stillbirth.
abstract: OBJECTIVE
  To describe the methods for assigning the cause of death for stillbirths enrolled in the Stillbirth Collaborative Research Network (SCRN).
  
  
  METHODS
  A complete evaluation, including postmortem examination, placental pathology, medical record abstraction, and maternal interview was available on 512 stillbirths among 500 women. These 512 stillbirths were evaluated for cause of death using the definitions outlined in this report. Using the best available evidence, SCRN investigators developed a new methodology to assign the cause of death of stillbirths using clinical, postmortem, and placental pathology data. This new tool, designated the Initial Causes of Fetal Death, incorporates known causes of death and assigns them as possible or probable based on strict diagnostic criteria, derived from published references and pathophysiologic sequences that lead to stillbirth.
  
  
  RESULTS
  Six broad categories of causes of death are accounted for, including maternal medical conditions; obstetric complications; maternal or fetal hematologic conditions; fetal genetic, structural, and karyotypic abnormalities; placental infection, fetal infection, or both; and placental pathologic findings. Isolated histologic chorioamnionitis and small for gestational age were not considered causes of death.
  
  
  CONCLUSIONS
  A new system, Initial Causes of Fetal Death, to assign cause of death in stillbirths was developed by the SCRN investigators for use in this study but has broader applicability. Initial Causes of Fetal Death is a standardized method to assign probable and possible causes of death of stillbirths based on information routinely collected during prenatal care and the clinical evaluation of fetal death.
authors.affiliation: From the University of Texas Health Science Center at San Antonio, Texas; Drexel University School of Medicine, Philadelphia, Pennsylvania; University of Utah School of Medicine, Salt Lake City, Utah; University of Texas Medical Branch, Galveston, Texas; Warren Alpert Medical School of Brown University, Providence, Rhode Island; Emory University School of Medicine, Children's Healthcare of Atlanta, Georgia; RTI International, Research Triangle Park, North Carolina; and Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Dudley
authors.forename: Robert
authors.initials: R
authors.lastname: Goldenberg
authors.forename: Deborah
authors.initials: D
authors.lastname: Conway
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Halit
authors.initials: H
authors.lastname: Pinar
authors.forename: Donald
authors.initials: D
authors.lastname: Coustan
authors.forename: Radek
authors.initials: R
authors.lastname: Bukowski
authors.forename: Barbara
authors.initials: B
authors.lastname: Stoll
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Koch
authors.forename: Corette B
authors.initials: CB
authors.lastname: Parker
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
mesh_terms: D004200:Diseases in Twins; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D050497:Stillbirth