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  • Peven, KimberlyLondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.;Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Pall, London, England. (författare)

Stillbirths including intrapartum timing: EN-BIRTH multi-country validation study.

  • Artikel/kapitelEngelska2021

Förlag, utgivningsår, omfång ...

  • 2021-03-26
  • Springer Science and Business Media LLC,2021

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/334090
  • https://gup.ub.gu.se/publication/334090URI
  • https://doi.org/10.1186/s12884-020-03238-7DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-442288URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • An estimated >2 million babies stillborn around the world each year lack visibility. Low- and middle-income countries carry 84% of the burden yet have the least data. Most births are now in facilities, hence routine register-recording presents an opportunity to improve counting of stillbirths, but research is limited, particularly regarding accuracy. This paper evaluates register-recorded measurement of hospital stillbirths, classification accuracy, and barriers and enablers to routine recording.The EN-BIRTH mixed-methods, observational study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017-2018). Clinical observers collected time-stamped data on perinatal care and birth outcomes as gold standard. To assess accuracy of routine register-recorded stillbirth rates, we compared birth outcomes recorded in labour ward registers to observation data. We calculated absolute rate differences and individual-level validation metrics (sensitivity, specificity, percent agreement). We assessed misclassification of stillbirths with neonatal deaths. To examine stillbirth appearance (fresh/macerated) as a proxy for timing of death, we compared appearance to observed timing of intrauterine death based on heart rate at admission.23,072 births were observed including 550 stillbirths. Register-recorded completeness of birth outcomes was > 90%. The observed study stillbirth rate ranged from 3.8 (95%CI = 2.0,7.0) to 50.3 (95%CI = 43.6,58.0)/1000 total births and was under-estimated in routine registers by 1.1 to 7.3 /1000 total births (register: observed ratio 0.9-0.7). Specificity of register-recorded birth outcomes was > 99% and sensitivity varied between hospitals, ranging from 77.7-86.1%. Percent agreement between observer-assessed birth outcome and register-recorded birth outcome was very high across all hospitals and all modes of birth (> 98%). Fresh or macerated stillbirth appearance was a poor proxy for timing of stillbirth. While there were similar numbers of stillbirths misclassified as neonatal deaths (17/430) and neonatal deaths misclassified as stillbirths (21/36), neonatal deaths were proportionately more likely to be misclassified as stillbirths (58.3% vs 4.0%). Enablers to more accurate register-recording of birth outcome included supervision and data use.Our results show these routine registers accurately recorded stillbirths. Fresh/macerated appearance was a poor proxy for intrapartum stillbirths, hence more focus on measuring fetal heart rate is crucial to classification and importantly reduction in these preventable deaths.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Day, Louise TLondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.,Int Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh. (författare)
  • Ruysen, HarrietLondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England. (författare)
  • Tahsina, Tazeen (författare)
  • KC, Ashish,1982Uppsala universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Internationell barnhälsa och nutrition,Global hälsa - implementering och hållbarhet(Swepub:uu)ashka967 (författare)
  • Shabani, JosephineIfakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, Dar Es Salaam, Tanzania. (författare)
  • Kong, StefanieLondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England. (författare)
  • Ameen, ShafiqulInt Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh. (författare)
  • Basnet, OmkarGolden Community, Res Div, Lalitpur, Nepal. (författare)
  • Haider, RajibInt Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh. (författare)
  • Rahman, Qazi Sadeq-UrInt Ctr Diarrhoeal Dis Res Bangladesh Iccdr B, Maternal & Child Hlth Div, Dhaka, Bangladesh. (författare)
  • Blencowe, HannahLondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England. (författare)
  • Lawn, Joy ELondon Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England. (författare)
  • London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.;Kings Coll London, Florence Nightingale Fac Nursing Midwifery & Pall, London, England.London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England. (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:BMC pregnancy and childbirth: Springer Science and Business Media LLC21:Suppl 11471-2393

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