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Table 1 Definitions of the characteristics included in the 13 categories of causes of perinatal deaths by NICE classification

From: Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000–2010: a registry based study

Causes

Characteristics*

1. Congenital anomalies:

Include stillborn and liveborn infants with lethal malformations or potentially lethal malformations that markedly increase mortality risk.

2. Multiple births:

Includes multiple births other than duplex, or duplex in combination with immaturity (<33 gestational weeks) or intrauterine deaths.

3. Maternal disease:

Maternal diabetes mellitus if the infant is stillborn or is large for date (Z-score >2 SD). Maternal pre-eclampsia, renal disease, hepatosis, epilepsy, systemic lupus erythematosus (SLE) included when combined with an infant either small for date (Z-score <−2 SD) or immature (<33 gestational weeks), or dead before labour.

4. Specific fetal conditions:

Isoimmunization, unexplained hydrops featalis, tumors and specific fetal infections. Accidents included when combined with stillbirth.

5. Unexplained SGA infants:

Infants Z-score <−2.5 SD without any evidence of maternal disorder.

6. Placental abruption:

If combined with asphyxia, immaturity (<33 gestational weeks) or intrauterine death.

7. Obstetric complications:

Uterine rupture, disproportion, malpresentation, cord prolapse, cord compression, placenta previa, foetal blood loss and precipitated labour.

8. Unexplained antepartum stillbirths

<37 gestational weeks

9. Unexplained antepartum stillbirths

>36 gestational weeks

10. Specific infant conditions:

Liveborn infants >32 gestational weeks with septicaemia, meningitis or pnaeumonia, includes term infants with respiratory distress syndrome (RDS) or sudden infant death syndrome (SIDS). Accidents included when causing neonatal death.

11. Unexplained asphyxia:

Intrapartum death, deaths occur < 4 hrs after birth and cases with Apgar score <7 at 5 min, where the asphyxia is not explained, clinical diagnosis Hypoxic ischaemic encephalopathy (HIE) or severe birth asphyxia where Apgar score is missing and the case does not belong to groups 1–10 above. Immature infants 27 gestational weeks or < 1000 g are excluded.

12. Unexplained immaturity:

Liveborn infants <33 gestational weeks and 2500 g (or 1800 g if gestational age is unknown) where the immaturity is not explained and the case does not belong to groups 1–11 above.

13. Unclassifiable cases:

Cases not in groups 1–12.

  1. *Characteristics included in the 13 categories adapted and modified from Winbo et al. [23]. Modifications are bolded.