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. 1993 Aug;83(8):1088–1091. doi: 10.2105/ajph.83.8.1088

The coding of underlying cause of death from fetal death certificates: issues and policy considerations.

R S Kirby 1
PMCID: PMC1695149  PMID: 8342713

Abstract

Recently, plans to implement nationwide coding of underlying cause of fetal death have been promulgated. To examine the validity and potential utility of nationwide coding, this paper presents data from a five-state (Wisconsin, Arkansas, Maine, North Carolina, California) analysis of underlying causes of fetal death from vital records for 1985 through 1987. Nosological coding rules varied somewhat from state to state. Underlying causes were grouped into categories; distributions were similar for each state. Many deaths (20.3% to 32.9%) were coded as unspecified conditions. Congenital anomalies accounted for only 6.9% to 10.3% of fetal deaths, including implausible and nonspecific causes. In total, 29.5% to 42.8% of the reports were not valid or useful. To obtain better data, researchers must focus on improving fetal death reporting, which will entail the promotion of comprehensive autopsy, placental and laboratory evaluation, systematic vital records query procedures, and implementation of multiple-cause-of-fetal-death coding.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alberman E. D., Creasy M. R. Frequency of chromosomal abnormalities in miscarriages and perinatal deaths. J Med Genet. 1977 Oct;14(5):313–315. doi: 10.1136/jmg.14.5.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Angell R. R., Sandison A., Bain A. D. Chromosome variation in perinatal mortality: a survey of 500 cases. J Med Genet. 1984 Feb;21(1):39–44. doi: 10.1136/jmg.21.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BAIRD D., WALKER J., THOMSON A. M. The causes and prevention of stillbirths and first week deaths. III. A classification of deaths by clinical cause; the effect of age, parity and length of gestation on death rates by cause. J Obstet Gynaecol Br Emp. 1954 Aug;61(4):433–448. doi: 10.1111/j.1471-0528.1954.tb07507.x. [DOI] [PubMed] [Google Scholar]
  4. Benirschke K., Robb J. A. Infectious causes of fetal death. Clin Obstet Gynecol. 1987 Jun;30(2):284–294. doi: 10.1097/00003081-198706000-00008. [DOI] [PubMed] [Google Scholar]
  5. Carey J. C. Diagnostic evaluation of the stillborn infant. Clin Obstet Gynecol. 1987 Jun;30(2):342–351. doi: 10.1097/00003081-198706000-00013. [DOI] [PubMed] [Google Scholar]
  6. Christensen K. K. Infection as a predominant cause of perinatal mortality. Obstet Gynecol. 1982 Apr;59(4):499–508. [PubMed] [Google Scholar]
  7. Cole S., Hartford R. B., Bergsjø P., McCarthy B. International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. III: A method of grouping underlying causes of infant death to aid international comparisons. Acta Obstet Gynecol Scand. 1989;68(2):113–117. doi: 10.3109/00016348909009897. [DOI] [PubMed] [Google Scholar]
  8. Dickson N., Bhula P., Wilson P. D. Use of classification of primary obstetric factors in perinatally related mortality surveillance. N Z Med J. 1988 May 11;101(845):228–231. [PubMed] [Google Scholar]
  9. Eberstein I. W., Nam C. B., Hummer R. A. Infant mortality by cause of death: main and interaction effects. Demography. 1990 Aug;27(3):413–430. [PubMed] [Google Scholar]
  10. Georgsdóttir I., Geirsson R. T., Jóhannsson J. H., Biering G., Snaedal G. Classification of perinatal and late neonatal deaths in Iceland. A survey from a defined population. Acta Obstet Gynecol Scand. 1989;68(2):101–108. doi: 10.3109/00016348909009895. [DOI] [PubMed] [Google Scholar]
  11. Goldhaber M. K. Fetal death ratios in a prospective study compared to state fetal death certificate reporting. Am J Public Health. 1989 Sep;79(9):1268–1270. doi: 10.2105/ajph.79.9.1268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Greb A. E., Pauli R. M., Kirby R. S. Accuracy of fetal death reports: comparison with data from an independent stillbirth assessment program. Am J Public Health. 1987 Sep;77(9):1202–1206. doi: 10.2105/ajph.77.9.1202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Harter L., Starzyk P., Frost F. A comparative study of hospital fetal death records and Washington State fetal death certificates. Am J Public Health. 1986 Nov;76(11):1333–1334. doi: 10.2105/ajph.76.11.1333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hopkins D. D., Grant-Worley J. A., Bollinger T. L. Survey of cause-of-death query criteria used by state vital statistics programs in the US and the efficacy of the criteria used by the Oregon Vital Statistics Program. Am J Public Health. 1989 May;79(5):570–574. doi: 10.2105/ajph.79.5.570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hovatta O., Lipasti A., Rapola J., Karjalainen O. Causes of stillbirth: a clinicopathological study of 243 patients. Br J Obstet Gynaecol. 1983 Aug;90(8):691–696. doi: 10.1111/j.1471-0528.1983.tb09296.x. [DOI] [PubMed] [Google Scholar]
  16. Keeling J. W., MacGillivray I., Golding J., Wigglesworth J., Berry J., Dunn P. M. Classification of perinatal death. Arch Dis Child. 1989 Oct;64(10 Spec No):1345–1351. doi: 10.1136/adc.64.10_spec_no.1345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lammer E. J., Brown L. E., Anderka M. T., Guyer B. Classification and analysis of fetal deaths in Massachusetts. JAMA. 1989 Mar 24;261(12):1757–1762. [PubMed] [Google Scholar]
  18. Mason J. O. Reducing infant mortality in the United States through "Healthy Start". Public Health Rep. 1991 Sep-Oct;106(5):479–483. [PMC free article] [PubMed] [Google Scholar]
  19. McIlwaine G. M., Dunn F. H., Howat R. C., Smalls M., Wyllie M. M., MacNaughton M. C. A routine system for monitoring perinatal deaths in Scotland. Br J Obstet Gynaecol. 1985 Jan;92(1):9–13. doi: 10.1111/j.1471-0528.1985.tb01041.x. [DOI] [PubMed] [Google Scholar]
  20. Morrison I., Olsen J. Weight-specific stillbirths and associated causes of death: an analysis of 765 stillbirths. Am J Obstet Gynecol. 1985 Aug 15;152(8):975–980. doi: 10.1016/0002-9378(85)90542-3. [DOI] [PubMed] [Google Scholar]
  21. Mueller R. F., Sybert V. P., Johnson J., Brown Z. A., Chen W. J. Evaluation of a protocol for post-mortem examination of stillbirths. N Engl J Med. 1983 Sep 8;309(10):586–590. doi: 10.1056/NEJM198309083091004. [DOI] [PubMed] [Google Scholar]
  22. Naeye R. L. Causes of perinatal mortality in the US Collaborative Perinatal Project. JAMA. 1977 Jul 18;238(3):228–229. [PubMed] [Google Scholar]
  23. Rogers R. G. Ethnic and birth weight differences in cause-specific infant mortality. Demography. 1989 May;26(2):335–343. [PubMed] [Google Scholar]
  24. Stafford P. A., Biddinger P. W., Zumwalt R. E. Lethal intrauterine fetal trauma. Am J Obstet Gynecol. 1988 Aug;159(2):485–489. doi: 10.1016/s0002-9378(88)80115-7. [DOI] [PubMed] [Google Scholar]

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