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Related Experiment Videos

Classification of perinatal death.

J W Keeling1, I MacGillivray, J Golding

  • 1Department of Histopathology, John Radcliffe Maternity Hospital, Oxford.

Archives of Disease in Childhood
|October 1, 1989
PubMed
Summary
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This study validated the Wigglesworth classification for perinatal deaths. Minor changes occurred with additional data, but classifier disagreement highlights the need for clearer definitions in perinatal death classification.

Area of Science:

  • Perinatal Medicine
  • Pathology
  • Epidemiology

Background:

  • The Wigglesworth classification is a standard for categorizing perinatal deaths.
  • Accurate classification is crucial for understanding causes of death and improving outcomes.
  • Previous validation studies have not fully assessed the impact of comprehensive data.

Purpose of the Study:

  • To validate the Wigglesworth classification system for perinatal deaths.
  • To assess the impact of incorporating different data sets (clinical, necropsy, histological) on classification.
  • To identify areas of ambiguity and disagreement in the classification process.

Main Methods:

  • Six specialists independently classified 239 perinatal deaths using varying data levels: clinical data only, clinical plus gross necropsy, and complete data (clinical, necropsy, histology, ancillary tests).

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  • Inter-classifier agreement was assessed at each data level.
  • Amendments to the Wigglesworth classification definitions were proposed.

    • Main Results:

    • Classification stability was high: only 6% of deaths changed category with gross necropsy findings added to clinical data.
    • Complete investigations resulted in only 9% of deaths changing classification.
    • Significant inter-classifier disagreement (15%) was observed, primarily due to inconsistent application of classification rules.

    Conclusions:

    • The Wigglesworth classification demonstrates reasonable stability across different data completeness levels.
    • Inter-classifier disagreement underscores the need for clearer definitions and standardized application of the Wigglesworth criteria.
    • Proposed amendments aim to reduce ambiguity and improve the reliability of perinatal death classification.