title: Application of ICD-PM to preterm-related neonatal deaths in South Africa and United Kingdom.
abstract: We explore preterm-related neonatal deaths using the WHO application of the International Classification of Disease (ICD-10) to deaths during the perinatal period: ICD-PM as an informative case study, where ICD-PM can improve data use to guide clinical practice and programmatic decision-making.
  
  
  
  Retrospective application of ICD-PM.
  
  
  
  South Africa, and the UK.
  
  
  
  Perinatal death databases.
  
  
  
  Descriptive analysis of neonatal deaths and maternal conditions present.
  
  
  
  Causes of preterm neonatal mortality and associated maternal conditions.
  
  
  
  We included 98 term and 173 preterm early neonatal deaths from South Africa, and 956 term and 3248 preterm neonatal deaths from the UK. In the South African data set, the main causes of death were respiratory/cardiovascular disorders (34.7%), low birthweight/prematurity (29.2%), and disorders of cerebral status (25.5%). Amongst preterm deaths, low birthweight/prematurity (43.9%) and respiratory/cardiovascular disorders (32.4%) were the leading causes. In the data set from the UK, the leading causes of death were low birthweight/prematurity (31.6%), congenital abnormalities (27.4%), and deaths of unspecified cause (26.1%). In the preterm deaths, the leading causes were low birthweight/prematurity (40.9%) and deaths of unspecified cause (29.6%). In South Africa, 61% of preterm deaths resulted from the maternal condition of preterm spontaneous labour. Among the preterm deaths in the data set from the UK, no maternal condition was present in 36%, followed by complications of placenta, cord, and membranes (23%), and other complications of labour and delivery (22%).
  
  
  
  ICD-PM can be used to appraise the maternal and newborn conditions contributing to preterm deaths, and can inform practice.
  
  
  
  ICD-PM can be used to appraise maternal and newborn contributors to preterm deaths to improve quality of care.
authors.affiliation: School of Women's and Infants' Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Crawley, WA, Australia. 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. 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: J P
authors.initials: JP
authors.lastname: Vogel
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: Ӧ
authors.initials: Ӧ
authors.lastname: Tunçalp
authors.affiliation: Perinatal Institute, Edgbaston, 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, Edgbaston, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Francis
authors.affiliation: Department of Obstetrics, University Medical Center Groningen, University of 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, QLD, 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.|Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway.
authors.forename: J F
authors.initials: JF
authors.lastname: Frøen
authors.affiliation: 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, WA, 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; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D066087:Perinatal Death; D012189:Retrospective Studies; D013019:South Africa
keywords: ICD; Classification; global; perinatal death; preterm deaths