Assessment of potentially avoidable perinatal mortality in a regionalized program.

Area of Science:

• Perinatal Medicine
• Public Health
• Epidemiology

Background:

• Perinatal mortality remains a significant concern in maternal and child health.
• Understanding the factors contributing to perinatal deaths is crucial for developing effective interventions.
• Previous reviews have varied in scope and methodology, necessitating a standardized approach.

Purpose of the Study:

• To prospectively collect and analyze data on perinatal mortality.
• To identify factors influencing perinatal deaths and assess their potential avoidability.
• To establish a standardized classification system for perinatal mortality reviews.

Main Methods:

• A comprehensive perinatal mortality review project was implemented over 21 months.
• Data were collected from two perinatal centers and ten community hospitals, encompassing all perinatal deaths.
• Each case was assessed for potential avoidability using a defined criterion: if any factor could have altered the outcome.

Main Results:

• The study included 26,937 live births and 591 cases of perinatal mortality.
• Potentially avoidable factors were identified in 21% of perinatal deaths.
• 74% of cases were classified as unavoidable, and 5% were undetermined due to insufficient data.

Conclusions:

• Standardized review of all perinatal deaths yields meaningful data on influencing factors.
• A significant proportion of perinatal deaths present opportunities for intervention through identification of avoidable factors.
• The review process facilitated recognition of patterns in potentially avoidable perinatal deaths, informing quality improvement initiatives.