Classification of perinatal deaths: development of the Australian and New Zealand classifications

Area of Science:

• Perinatal Medicine
• Public Health Surveillance
• Medical Classification Systems

Background:

• Perinatal death classifications are crucial for surveillance and auditing to improve care.
• Previous classifications have limitations in comprehensively addressing all contributing factors.
• The need for standardized, reproducible classification systems is well-established.

Purpose of the Study:

• To describe the history and development of the Perinatal Society of Australia and New Zealand (PSANZ) paired obstetric and neonatal death classifications.
• To provide an overview of the PSANZ classifications in the context of other existing systems.
• To highlight the features and utility of the PSANZ classifications for perinatal mortality review.

Main Methods:

• The PSANZ Perinatal Death Classification was developed based on obstetric antecedent factors.
• The PSANZ Neonatal Death Classification was developed based on fetal and neonatal factors.
• Historical review and contextualization within other classification systems were employed.

Main Results:

• The PSANZ Perinatal Death Classification focuses on the sequence of obstetric events leading to death.
• The PSANZ Neonatal Death Classification addresses factors directly related to the fetus and neonate.
• The classifications demonstrate a high level of agreement between classifiers and are widely adopted.

Conclusions:

• The PSANZ classifications offer a standardized approach to perinatal death review.
• These classifications facilitate the identification of suboptimal care and the implementation of preventive strategies.
• The widespread use of the PSANZ classifications in Australia and New Zealand supports their effectiveness.