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Table 2 Widely used classification systems for causes of stillbirth and neonatal death, 2009–2014: Selected characteristics

From: Seeking order amidst chaos: a systematic review of classification systems for causes of stillbirth and neonatal death, 2009–2014

  Country of origina Region and countries of use (2009–2014)b # deaths classified (2009–2014)b Hier IP vs AP SB vs NND cats Single cause # causes # levels Ass'd factors Ass'd factors vs causes Defs Rules Max % unex
Systems classifying both SB and NND
 CMACE 2010-maternal & fetal [36] UK HIC (UK) 6,804 No Yes No No 13 2 Yes No Some Yes 39 %
 CMACE 2011-maternal & fetal [46] UK HIC (UK, Wales) 9,786 No Yes No Yes 12 3 Yes No No No 51 %
 Cole 1986 [26] UK Both (Nigeria, Netherlands) 345 Partly No No Yes 10 2 No n/a Yes Yes 55 %
 Engmann 2012 [39] USA LMIC (Guatemala, DRC, Zambia, Pakistan) 252 No Partial Yes, all Yes 7.5c 1 No n/a No No 12 %
 Flenady 2009-PSANZ-PDC [28] Australia Both (Australia, Vietnam, New Zealand, Madagascar) 13,416 Partly Partial No Yes 7 4 Yes Yes Some Yes 54 %
 Frøen 2009-Codac [11] Norway HIC (Norway, Italy, Wales) 872 Partly Yes Some Yes 10 3 Yes Yes Some Yes 53 %
 Korteweg 2006-Tulip [35] Neth. HIC (Neth.) 3,603 No No No Yes 6 3 Yes Yes Some Yes 23 %
 Manandhar 2010 [47] Nepal LMIC (Nepal) 1,272 Unclear Yes Yes, all Yes 9c 1 No n/a Yes No 10 %
 National Services Scotland 2013-FIGO [27] Scotland HIC (Scotland) 1,249 No No Yes, all Yes 4 1 No n/a No No 100%d
 MRC 2002-PPIP [48] South Africa LMIC (South Africa) 47,238 No Partial Some Unclear 9.5c 1 Yes Yes Some No 35 %
 Wigglesworth 1980 [7] UK Both (Turkey, Bangladesh, UK, Ireland, Nepal, Pakistan, Brazil) 4,558 No Partial Some Yes 5 1 No n/a Some Yes 56 %
 Winbo 1998-NICE [31] Sweden LMIC (Tanzania) 2,494 Yes No Some Yes 13 1 No n/a Yes No 46 %
 Wood 2012 [49] UK HIC (Scotland) 8,332 No Yes Some Yes 2 2 No n/a Yes No 60 %
Systems classifying SB only  
 Dudley 2010-INCODE [34] USA HIC (Canada, USA) 1,075 No Partial n/a No 7 4 No n/a Some Yes n/ae
 Gardosi 2005-ReCoDe [37] UK Both (Italy, UK, France, Portugal, New Zealand, Germany, Brazil) 25,779 Yes Partial n/a No 9 2 Yes No Some Yes 26 %
 Seaton 2012 [50] UK HIC (UK) 21,352 No Partial n/a Yes 9 1 No n/a Yes No 41 %
 Varli 2008-Stockholm [33] Sweden HIC (Sweden) 1,089 No No n/a Yes 17 2 Yes No Yes Yes 19 %
Systems classifying NND only  
 Black 2010-CHERG [51] USA Global >1 million No n/a n/a Yes 8 1 No n/a Some Yes 23 %
 CMACE 2010-neonatal [36] UK HIC (UK, Ireland) 7,717 No n/a n/a No 10 2 Yes No Some Yes 6 %
 Cole 1989-ICE [52] UK HIC (Canada, USA) 38,692 No n/a n/a Yes 8 1 No n/a Yes Yes 15 %
 Flenady 2009-PSANZ-NDC [28] Australia HIC (Australia, New Zealand) 3,449 No n/a n/a Yes 11 3 Yes Yes Some Yes n/af
 Lawn 2006-CHERG [53] South Africa Both (sub-Saharan Africa, Laos, Uganda); also global >1 million Yes n/a n/a Yes 7 1 No n/a Yes Yes 23 %
 Lawn 2012 [54] South Africa Global >1 million No n/a n/a Yes 5 1 No n/a No No n/af
 Lawn 2010 [55] South Africa Global >1 million No n/a n/a Yes 5 1 No n/a No No n/af
 Rocha 2011 [56] Brazil LMIC (Brazil) 2,893 No n/a n/a Unclear 6 2 No n/a No No 20 %
 Smith 2010 [57] UK HIC (UK) 18,524 Yes n/a n/a Yes 10 1 No n/a No No 5 %
 Winter 2013-Rwanda [58] Rwanda LMIC (Bhutan, Rwanda) 628 No n/a n/a Yes 7 1 No n/a No No n/af
  1. Hier Hierarchical or not, IP vs AP Requires distinguishing antepartum from intrapartum stillbirth, SB vs NND cats Includes separate categories for stillbirths and neonatal deaths, Single cause Requires single cause to be identified, # causes Number of causes at top level, Ass’d factors Allows associated factors to be recorded, Ass’d factors vs causes Requires associated factors and causes to be distinguished from one another, Defs Includes definitions for all causes, Rules Includes guidelines for assigning cause of death, Max % unex Maximum percent of deaths classified as “unexplained” (see Additional file 10 for more detail)
  2. NOTE: All data other than region/countries of use and number of deaths classified was taken from reference papers for included systems, which are cited in the first column. “Widely used” is defined as used to classify >1000 deaths and/or in 2+ countries between 2009 and 2014
  3. aDefined as country of first affiliation of first author of reference paper
  4. bRegion and countries of use and numbers of deaths classified all taken exclusively from included papers between 2009 and 2014 that reported use of the included systems
  5. cAverage taken when there was more than one set of levels (e.g. one for stillbirths and one for neonatal deaths)
  6. dThe system only allocates stillbirths to one of two “causes”, both of which are considered to be “unexplained”; see Additional file 10 for more detail
  7. e The system has a category for “unexplained” but there was no data reported
  8. f These systems have no category for “unexplained”
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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