title: The WHO application of ICD-10 to deaths during the perinatal period (ICD-PM): results from pilot database testing in South Africa and United Kingdom.
abstract: To apply the World Health Organization (WHO) Application of the International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period: ICD-Perinatal Mortality (ICD-PM) to existing perinatal death databases.
  
  
  
  Retrospective application of ICD-PM.
  
  
  
  South Africa, UK.
  
  
  
  Perinatal death databases.
  
  
  
  Deaths were grouped according to timing of death and then by the ICD-PM cause of death. The main maternal condition at the time of perinatal death was assigned to each case.
  
  
  
  Causes of perinatal mortality, associated maternal conditions.
  
  
  
  In South Africa 344/689 (50%) deaths occurred antepartum, 11% (n = 74) intrapartum and 39% (n = 271) in the early neonatal period. In the UK 4377/9067 (48.3%) deaths occurred antepartum, with 457 (5%) intrapartum and 4233 (46.7%) in the neonatal period. Antepartum deaths were due to unspecified causes (59%), chromosomal abnormalities (21%) or problems related to fetal growth (14%). Intrapartum deaths followed acute intrapartum events (69%); neonatal deaths followed consequences of low birthweight/ prematurity (31%), chromosomal abnormalities (26%), or unspecified causes in healthy mothers (25%). Mothers were often healthy; 53%, 38% and 45% in the antepartum, intrapartum and neonatal death groups, respectively. Where there was a maternal condition, it was most often maternal medical conditions, and complications of placenta, cord and membranes.
  
  
  
  The ICD-PM can be a globally applicable perinatal death classification system that emphasises the need for a focus on the mother-baby dyad as we move beyond 2015.
  
  
  
  ICD-PM is a global system that classifies perinatal deaths and links them to maternal conditions.
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia. Emma.allanson@gmail.com, allansone@who.int.|Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. Emma.allanson@gmail.com, allansone@who.int.
authors.forename: E R
authors.initials: ER
authors.lastname: Allanson
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Tunçalp
authors.affiliation: Perinatal Institute, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gardosi
authors.affiliation: SAMRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa.
authors.forename: R C
authors.initials: RC
authors.lastname: Pattinson
authors.affiliation: Perinatal Institute, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Francis
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: J P
authors.initials: JP
authors.lastname: Vogel
authors.affiliation: Department of Obstetrics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
authors.forename: Jjhm
authors.initials: J
authors.lastname: Erwich
authors.affiliation: Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, Queensland, Australia.|International Stillbirth Alliance, Bristol, UK.
authors.forename: V J
authors.initials: VJ
authors.lastname: Flenady
authors.affiliation: Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: J F
authors.initials: JF
authors.lastname: Frøen
authors.affiliation: Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway.|Centre for Women's Health Research, University of Liverpool, Liverpool, UK.
authors.forename: J
authors.initials: J
authors.lastname: Neilson
authors.affiliation: Pacific Northwest University of Health Sciences, Yakima, Washington, USA.
authors.forename: A
authors.initials: A
authors.lastname: Quach
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Chou
authors.affiliation: Maternal & Perinatal Health, Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Mathai
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Say
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: A M
authors.initials: AM
authors.lastname: Gülmezoglu
mesh_terms: D002423:Cause of Death; D005260:Female; D006801:Humans; D007226:Infant Mortality; D038801:International Classification of Diseases; D010865:Pilot Projects; D011247:Pregnancy; D012189:Retrospective Studies; D013019:South Africa
keywords: Classification; International Classification of Diseases; global; monitoring; perinatal death; stillbirth