ArticlePloS one2019
Application of the ICD-PM classification system to stillbirth in four sub-Saharan African countries.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Perinatal mortality in eastern Africa: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Pooled it
- A systematic review and meta-analysis of the globally reported International Classification of Diseases to Perinatal Mortality (ICD-PM).Frontiers in medicine · 2024Pooled it
- The global use of the International Classification of Diseases to Perinatal Mortality (ICD-PM): A systematic review.Journal of global health · 2022Pooled it
- (De)coding perinatal deaths: applying the International Classification of Diseases to perinatal mortality to a perinatal e-registry from 16 hospitals in Benin, Malawi, Tanzania, and Uganda.Global health action · 2026Article
- Levels of in-facility maternal mortality, obstetric complications and stillbirths in three urban referral hospitals in Guinea: analysis of routine data from May 2021 to April 2023.BMJ global health · 2026Article
- Use of the International Classification of Diseases to Perinatal Mortality (ICD-PM) with verbal autopsy to determine the causes of stillbirths and neonatal deaths in rural Cambodia: a population-based, prospective, cohort study.The Lancet regional health. Western Pacific · 2025Article
- Improving the Documentation of Causes of Death Certificates Based on the International Classification of Diseases Perinatal Mortality (ICD-PM): The Impact of a Mixed Method Approach.Health science reports · 2025Article
- Can International Classification of Disease Perinatal Mortality (ICD-PM) be a solution to overcome neglected tragedy? A scoping reviews.Health science reports · 2024Article
- Evaluating the accuracy of International Classification of Disease Perinatal Mortality (ICD-PM) codes assigned on death certificates before and after expert panel review: a mixed methods observational study.BMC pregnancy and childbirth · 2024Observational
- Effect of optimal antenatal care on maternal and perinatal health in Ethiopia.Frontiers in pediatrics · 2023Article
- Timing of perinatal death; causes, circumstances, and regional variations among reviewed deaths in Ethiopia.PloS one · 2023Article
- Stillbirth incidence and determinants in a tertiary health facility in the Volta Region of Ghana.PloS one · 2023Article
- Determinants of stillbirth among reviewed perinatal deaths in Ethiopia.Frontiers in pediatrics · 2022Article
- Cause and risk factors of early neonatal death in Ethiopia.PloS one · 2022Article
- Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment.Lancet (London, England) · 2021Article
- Understanding the complexities of unexplained stillbirth in sub-Saharan Africa: a mixed-methods study.BJOG : an international journal of obstetrics and gynaecology · 2021Article
- Article
- Stillbirths in China: a nationwide survey.BJOG : an international journal of obstetrics and gynaecology · 2021Article
- Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case-control study.PloS one · 2021Article
- Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data.Global health action · 2020Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify the causes and categories of stillbirth using the Application of ICD-10 to Deaths during the Perinatal Period (ICD-PM).
methodsProspective, observational study in 12 hospitals across Kenya, Malawi, Sierra Leone and Zimbabwe. Healthcare providers (HCPs) assigned cause of stillbirth following perinatal death audit. Cause of death was classified using the ICD-PM classification system.
findings1267 stillbirths met the inclusion criteria. The stillbirth rate (per 1000 births) was 20.3 in Malawi (95% CI: 15.0-42.8), 34.7 in Zimbabwe (95% CI: 31.8-39.2), 38.8 in Kenya (95% CI: 33.9-43.3) and 118.1 in Sierra Leone (95% CI: 115.0-121.2). Of the included cases, 532 (42.0%) were antepartum deaths, 643 (50.7%) were intrapartum deaths and 92 cases (7.3%) could not be categorised by time of death. Overall, only 16% of stillbirths could be classified by fetal cause of death. Infection (A2 category) was the most commonly identified cause for antepartum stillbirths (8.6%). Acute intrapartum events (I3) accounted for the largest proportion of intrapartum deaths (31.3%). In contrast, for 76% of stillbirths, an associated maternal condition could be identified. The M1 category (complications of placenta, cord and membranes) was the most common category assigned for antepartum deaths (31.1%), while complications of labour and delivery (M3) accounted for the highest proportion of intrapartum deaths (38.4%). Overall, the proportion of cases for which no fetal or maternal cause could be identified was 32.6% for antepartum deaths, 8.1% for intrapartum deaths and 17.4% for cases with unknown time of death.
conclusionClinical care and documentation of this care require strengthening. Diagnostic protocols and guidelines should be introduced more widely to obtain better data on cause of death, especially antepartum stillbirths. Revision of ICD-PM should consider an additional category to help accommodate stillbirths with unknown time of death.
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