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Classification of perinatal mortality.

J A Low, R W Boston, F G Crussi

    Canadian Medical Association Journal
    |November 20, 1971
    PubMed
    Summary
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    This study classifies perinatal mortality by cause, finding fetal insufficiency and respiratory failure are primary drivers. Understanding these mechanisms by gestational age is crucial for reducing infant deaths.

    Area of Science:

    • Perinatal Medicine
    • Neonatology
    • Obstetrics

    Background:

    • Perinatal mortality remains a significant concern in neonatal and obstetric care.
    • Current classifications may not fully capture the underlying pathophysiological mechanisms.
    • A unified approach to stillbirth and neonatal mortality is needed.

    Purpose of the Study:

    • To classify perinatal mortality based on pathophysiological mechanisms.
    • To analyze the relevance of each mechanism across different gestational ages.
    • To emphasize the impact of prematurity on perinatal death causes.

    Main Methods:

    • Classification of perinatal mortality by pathophysiological mechanisms.
    • Secondary subclassification based on gestational maturity.

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  • Analysis of mechanism relevance in mature versus premature infants.

    • Main Results:

    • Fetal insufficiency (40%) and respiratory failure (30%) are the leading causes of perinatal mortality.
    • Prematurity accounts for 66% of total perinatal mortality.
    • Neonatal respiratory failure is the principal mechanism in premature infants (20-28 weeks), while fetal insufficiency dominates in mature infants.

    Conclusions:

    • A pathophysiological classification provides valuable insights into perinatal mortality.
    • Gestational maturity significantly influences the primary cause of perinatal death.
    • Focusing on perinatal mortality as a whole, rather than separate stillbirth and neonatal mortality, is recommended for improved outcomes.