Stillbirth classification-developing an international consensus for research: Executive summary of a national institute of child health and human development workshop

Uma M. Reddy, Robert Goldenberg, Robert Silver, Gordon C.S. Smith, Richard M. Pauli, Ronald J. Wapner, Jason Gardosi, Halit Pinar, Marjorie Grafe, Michael Kupferminc, Ingela Hulthén Varli, Jan Jaap H.M. Erwich, Ruth C. Fretts, Marian Willinger

Research output: Contribution to journalComment/debate

79 Scopus citations

Abstract

Stillbirth is a major obstetric complication, with 3.2 million stillbirths worldwide and 26,000 stillbirths in the United States every year. The Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop from October 22-24, 2007, to review the pathophysiology of conditions underlying stillbirth to define causes of death. The optimal classification system would identify the pathophysiologic entity initiating the chain of events that irreversibly led to death. Because the integrity of the classification is based on available pathologic, clinical, and diagnostic data, experts emphasized that a complete stillbirth workup should be performed. Experts developed evidence-based characteristics of maternal, fetal, and placental conditions to attribute a condition as a cause of stillbirth. These conditions include infection, maternal medical conditions, antiphospholipid syndrome, heritable thrombophilias, red cell alloimmunization, platelet alloimmunization, congenital malformations, chromosomal abnormalities including confined placental mosaicism, fetomaternal hemorrhage, placental and umbilical cord abnormalities including vasa previa and placental abruption, complications of multifetal gestation, and uterine complications. In all cases, owing to lack of sufficient knowledge about disease states and normal development, there will be a degree of uncertainty regarding whether a specific condition was indeed the cause of death.

Original languageEnglish (US)
Pages (from-to)901-914
Number of pages14
JournalObstetrics and gynecology
Volume114
Issue number4
DOIs
StatePublished - Oct 1 2009

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Reddy, U. M., Goldenberg, R., Silver, R., Smith, G. C. S., Pauli, R. M., Wapner, R. J., Gardosi, J., Pinar, H., Grafe, M., Kupferminc, M., Hulthén Varli, I., Erwich, J. J. H. M., Fretts, R. C., & Willinger, M. (2009). Stillbirth classification-developing an international consensus for research: Executive summary of a national institute of child health and human development workshop. Obstetrics and gynecology, 114(4), 901-914. https://doi.org/10.1097/AOG.0b013e3181b8f6e4