PLoS ONE (Jan 2022)

Insights on the differentiation of stillbirths and early neonatal deaths: A study from the Child Health and Mortality Prevention Surveillance (CHAMPS) network.

  • Elizabeth Quincer,
  • Rebecca Philipsborn,
  • Diane Morof,
  • Navit T Salzberg,
  • Pio Vitorino,
  • Sara Ajanovic,
  • Dickens Onyango,
  • Ikechukwu Ogbuanu,
  • Nega Assefa,
  • Samba O Sow,
  • Portia Mutevedzi,
  • Shams El Arifeen,
  • Beth A Tippet Barr,
  • J Anthony G Scott,
  • Inacio Mandomando,
  • Karen L Kotloff,
  • Amara Jambai,
  • Victor Akelo,
  • Carrie Jo Cain,
  • Atique Iqbal Chowdhury,
  • Tadesse Gure,
  • Kitiezo Aggrey Igunza,
  • Farzana Islam,
  • Adama Mamby Keita,
  • Lola Madrid,
  • Sana Mahtab,
  • Ashka Mehta,
  • Paul K Mitei,
  • Constance Ntuli,
  • Julius Ojulong,
  • Afruna Rahman,
  • Solomon Samura,
  • Diakaridia Sidibe,
  • Bukiwe Nana Thwala,
  • Rosauro Varo,
  • Shabir A Madhi,
  • Quique Bassat,
  • Emily S Gurley,
  • Dianna M Blau,
  • Cynthia G Whitney

DOI
https://doi.org/10.1371/journal.pone.0271662
Journal volume & issue
Vol. 17, no. 7
p. e0271662

Abstract

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IntroductionThe high burden of stillbirths and neonatal deaths is driving global initiatives to improve birth outcomes. Discerning stillbirths from neonatal deaths can be difficult in some settings, yet this distinction is critical for understanding causes of perinatal deaths and improving resuscitation practices for live born babies.MethodsWe evaluated data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network to compare the accuracy of determining stillbirths versus neonatal deaths from different data sources and to evaluate evidence of resuscitation at delivery in accordance with World Health Organization (WHO) guidelines. CHAMPS works to identify causes of stillbirth and death in children ResultsOf 1967 deaths ultimately classified as stillbirth, only 28 (1.4%) were initially reported as livebirths. Of 845 cases classified as very early neonatal death, 33 (4%) were initially reported as stillbirth. Of 367 cases with post-mortem examination showing delivery weight >1000g and no maceration, the maternal clinical record documented that resuscitation was not performed in 161 cases (44%), performed in 14 (3%), and unknown or data missing for 192 (52%).ConclusionThis analysis found that CHAMPS cases assigned as stillbirth or neonatal death after DeCoDe expert panel review were generally consistent with the initial report of the case as a stillbirth or neonatal death. Our findings suggest that more frequent use of resuscitation at delivery and improvements in documentation around events at birth could help improve perinatal outcomes.