[Perinatal death classification in Iceland 1994-1998.]

To analyse perinatal deaths in Iceland (>22 weeks or 500 g) over a five year period by a new Nordic classification.

Medical records for all cases of perinatal death in Iceland from 1994-1998 were analysed. A classification focussing on potential avoidability from a health service perspective was used to identify major groups and areas for improvement. The classification is based on the following variables: time of death in relation to admission and delivery, fetal malformation, gestational age, growth-retardation and Apgar score at five minutes.

One hundred and fifty-eight perinatal deaths occurrecl. Of these 103 (65%) were stillborn babies and 55 were early neonatal deaths. The cumulative perinatal mortality rate (PNMR) was 7.3/1000 births for the period and all perinatal deaths, but using a cut-off point >28 weeks or 1000 g this was lower, 5.1/1000. Potentially avoidable groups accounted for 12% of the perinatal deaths, i.e. growthretarded singletons after >28 weeks and intrapartum deaths after >28 weeks. Almost half of the perinatal deaths (41.1%) could probably not be prevented with present methods in perinatal care. These included intrauterine deaths of non-growth retarded singletons after 28 weeks (27.8%) and intrauterine deaths be-fore 28 weeks, still considered miscarriages in some countries (13.3%). Two-thirds of the early neonatal.

The Nordic classification used gave a good picture of the causes of avoidable and unavoidable perinatal deaths and may facilitate comparison between populations and periods.