title: Characteristics of a global classification system for perinatal deaths: a Delphi consensus study.
abstract: Despite the global burden of perinatal deaths, there is currently no single, globally-acceptable classification system for perinatal deaths. Instead, multiple, disparate systems are in use world-wide. This inconsistency hinders accurate estimates of causes of death and impedes effective prevention strategies. The World Health Organisation (WHO) is developing a globally-acceptable classification approach for perinatal deaths. To inform this work, we sought to establish a consensus on the important characteristics of such a system.
  
  
  
  A group of international experts in the classification of perinatal deaths were identified and invited to join an expert panel to develop a list of important characteristics of a quality global classification system for perinatal death. A Delphi consensus methodology was used to reach agreement. Three rounds of consultation were undertaken using a purpose built on-line survey. Round one sought suggested characteristics for subsequent scoring and selection in rounds two and three.
  
  
  
  The panel of experts agreed on a total of 17 important characteristics for a globally-acceptable perinatal death classification system. Of these, 10 relate to the structural design of the system and 7 relate to the functional aspects and use of the system.
  
  
  
  This study serves as formative work towards the development of a globally-acceptable approach for the classification of the causes of perinatal deaths. The list of functional and structural characteristics identified should be taken into consideration when designing and developing such a system.
authors.affiliation: Mater Research Institute - The University of Queensland (MRI-UQ), Brisbane, Australia.|International Stillbirth Alliance, Bristol, UK.
authors.forename: Aleena M
authors.initials: AM
authors.lastname: Wojcieszek
authors.affiliation: Mater Research Institute - The University of Queensland (MRI-UQ), Brisbane, Australia.|International Stillbirth Alliance, Bristol, UK.
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Reinebrant
authors.affiliation: Mater Research Institute - The University of Queensland (MRI-UQ), Brisbane, Australia.|International Stillbirth Alliance, Bristol, UK.
authors.forename: Susannah Hopkins
authors.initials: SH
authors.lastname: Leisher
authors.affiliation: School of Women and Infants Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Australia.|Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Emma
authors.initials: E
authors.lastname: Allanson
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Coory
authors.affiliation: International Stillbirth Alliance, Bristol, UK.|The University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Jan Jaap
authors.initials: JJ
authors.lastname: Erwich
authors.affiliation: Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: J Frederik
authors.initials: JF
authors.lastname: Frøen
authors.affiliation: Perinatal Institute, Birmingham, UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Gardosi
authors.affiliation: International Stillbirth Alliance, Bristol, UK.|The University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Sanne
authors.initials: S
authors.lastname: Gordijn
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Metin
authors.initials: M
authors.lastname: Gulmezoglu
authors.affiliation: International Stillbirth Alliance, Bristol, UK.|Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK & St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Alexander E P
authors.initials: AE
authors.lastname: Heazell
authors.affiliation: Department of Obstetrics and Gynaecology, Martini Hospital, Groningen, The Netherlands.
authors.forename: Fleurisca J
authors.initials: FJ
authors.lastname: Korteweg
authors.affiliation: International Stillbirth Alliance, Bristol, UK.|Research Triangle Institute, Research Triangle Park, NC, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McClure
authors.affiliation: Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa.
authors.forename: Robert
authors.initials: R
authors.lastname: Pattinson
authors.affiliation: International Stillbirth Alliance, Bristol, UK.|University of Utah Health Sciences Center, Salt Lake City, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.affiliation: National Institute for Health Research, Biomedical Research Centre & Department of Obstetrics & Gynaecology, Cambridge University, Cambridge, UK.
authors.forename: Gordon
authors.initials: G
authors.lastname: Smith
authors.affiliation: Mater Research Institute - The University of Queensland (MRI-UQ), Brisbane, Australia.
authors.forename: Zheyi
authors.initials: Z
authors.lastname: Teoh
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Özge
authors.initials: Ö
authors.lastname: Tunçalp
authors.affiliation: Mater Research Institute - The University of Queensland (MRI-UQ), Brisbane, Australia. vicki.flenady@mater.uq.edu.au.|International Stillbirth Alliance, Bristol, UK. vicki.flenady@mater.uq.edu.au.
authors.forename: Vicki
authors.initials: V
authors.lastname: Flenady
mesh_terms: D002423:Cause of Death; D002965:Classification / Q000379:methods*; D032921:Consensus; D003697:Delphi Technique; D005260:Female; D014943:Global Health / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D066087:Perinatal Death / Q000209:etiology*; D011247:Pregnancy
keywords: Causes of death; Classification; Neonatal death; Perinatal death; Stillbirth; Systems