The Stockholm classification of stillbirth
Abstract
Objective To design and validate a classification system for audit groups working with stillbirth. The classification includes well-defined primary and associated conditions related to fetal death. Design Descriptive. Setting All delivery wards in Stockholm. Population Stillbirths from 22 completed weeks in Stockholm, Sweden. Methods Parallel to audit work, the Stockholm stillbirth group has developed a classification of conditions related to stillbirth. The classification has been validated. Main outcome measure The classification and the results of the validation are presented. Result The classification with 17 groups identifying underlying conditions related to stillbirth (primary diagnoses) and associated factors which may have contributed to the death (associated diagnoses) is described. The conditions are subdivided into definite, probable and possible relation to the death. An evaluation of 382 cases of stillbirth during 2002-2005 resulted in 382 primary diagnoses and 132 associated diagnoses. The most common conditions identified were intrauterine growth restriction/placental insufficiency (23%), infection (19%), malformations/chromosomal abnormalities (12%). The 'unexplained' group together with the 'unknown' group comprised 18%. Validation was done by reclassification of 95 cases from 2005 by six investigators. The overall agreement regarding primary diagnosis was substantial (kappa=0.70). Conclusions The Stockholm classification of stillbirth consists of 17 diagnos…
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In fetal and neonatal deaths, causes of death may relate to severe malformations or chromosomal abnormalities, but are also often findings compatible with live births, such as placental insufficiency, intrauterine growth restriction, and infection.
“In the case of fetal and neonatal deaths, causes of death may relate to severe malformations or chromosomal abnormalities, but are also often findings that can be compatible with live births too, such as placental insufficiency, intrauterine growth re striction, and infection (Varli et al., 2008).”
From Pregnancy-related maternal physiological adaptations and fetal chemical exposure (2023) · cites this paper as Varli et al., 2008
Even in the most thoroughly-studied cases, causes of fetal/neonatal death remain unestablished in about one fifth of cases.
“However, even in the most thoroughly-studied cases the causes remain unestablished in about one fifth of cases (Varli et al., 2008).”
From Pregnancy-related maternal physiological adaptations and fetal chemical exposure (2023) · cites this paper as Varli et al., 2008
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Causes of death among stillbirths
(2011) · JAMA · doi:10.1001/jama.2011.1823 · Cited by 444 · see citing works
Mamsen, L. S., Björvang, R. D., Mucs, D., Vinnars, M.-T., Papadogiannakis, N., Lindh, C. H., Andersen, C. Y., & Damdimopoulou, P. (2019) · Environment International · doi:10.1016/j.envint.2019.01.010 · Cited by 338 · see citing works
Self-citationPregnancy-related maternal physiological adaptations and fetal chemical exposure
Vinnars, M.-T., Bixo, M., & Damdimopoulou, P. (2023) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2023.112064 · Cited by 32 · see citing works
- Authors
- VARLI, I. H., PETERSSON, K., BOTTINGA, R., BREMME, K., HOFSJÖ, A., HOLM, M., HOLSTE, C., KUBLICKAS, M., NORMAN, M., PILO, C., ROOS, N., SUNDBERG, A., WOLFF, K., & PAPADOGIANNAKIS, N.
- Affiliations
- Karolinska University Hospital (SE)
- Karolinska Institutet (SE)
- Danderyds sjukhus (SE)
- Corresponding author
- VARLI, INGELA HULTHÉN
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2008-11
- Volume
- 87
- Issue
- 11
- Pages
- 1202-1212
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2052109087
- Cited by
- 83
- References
- 0
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 3
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- stillbirth, fetal death, classification systems, primary diagnosis, fetal growth restriction, placental insufficiency, infection, congenital malformations, chromosomal abnormalities, interobserver agreement
- MeSH terms
- Cause of Death, Classification, Female, Fetal Death, Fetal Diseases, Gestational Age, Humans, Obstetric Labor Complications, Pregnancy, Pregnancy Complications, Pregnancy Complications, Infectious, Risk Factors, Sweden, Stillbirth, Perinatal Mortality
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