Criteria for assigning cause of death for stillbirths and neonatal deaths in research studies in low-middle income countries
Open accessAbstract
Accurate knowledge regarding cause of death (COD) for stillbirths and neonatal deaths is crucial, especially in low-income countries, in order for public health and medical officials to choose appropriate interventions likely to reduce these deaths. To date, many of the COD studies in these areas have relied only on obstetric or neonatal clinical information and the determination of COD is likely to be inaccurate. Information related to infectious COD is especially lacking. Thus, without more sophisticated testing, data as currently collected only provide a very weak approximation of the COD and may well lead to adoption of interventions of limited usefulness. In this commentary, we propose recommendations regarding the type of data needed to determine with reasonable accuracy the COD for stillbirths and neonatal deaths in low-resource settings. Using these data, and a method to determine the degree of certainty, we then propose definitions for the most common COD. Our goal is to reduce subjectivity and provide more specificity for the tests used in existing classification systems so that the methodology of COD determination is transparent and able to be replicated over time and from location to location.
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Clinician-assigned cause of death may be inaccurate for several reasons, including lack of diagnostic tools such as autopsies, placental histology, X-rays, and lack of routine bacterial cultures.
“Clinician-assigned cause of death, which is the most common method used, may be inaccurate for several reasons, including lack of diagnostic tools such as autopsies, placental histology, X-rays, as well as lack of routine bacterial cultures [6, 7].”
From Neonatal deaths in rural Karnataka, India 2014–2018: a prospective population-based observational study in a low-resource setting (2020) · cites this paper as [7]
The Introduction (page unavailable) says that sparse clinical data and the lack of cultures, chest X-rays, autopsies, and placental histology can prevent accurate cause-of-death determination in low-resource settings. It also notes that clinicians can reach different conclusions. The paper does not establish the citing sentence’s additional assertion that clinician assignment is the most common method used. (LLM, conf=0.84)
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Flagged first, then by citations
Research works printed but not linked: 1
- McClure EM, Garces A, Saleem S, et al. Probable causes of stillbirth in low-and middle-income coun- tries using a prospectively defined classification sys- tem. BJOG. 2018;125(2):131-138.
Cited by
Sorted by citations
Dhaded, S. M., Somannavar, M. S., Moore, J. L., McClure, E. M., Vernekar, S. S., Yogeshkumar, S., Kavi, A., Ramadurg, U. Y., Nolen, T. L., Goldenberg, R. L., et al. (2020) · Reproductive Health · doi:10.1186/s12978-020-01014-6 · Cited by 13 · see citing works
Self-citation
- Authors
- Goldenberg, R. L., Muhe, L., Saleem, S., Dhaded, S., Goudar, S. S., Patterson, J., Nigussie, A., & McClure, E. M.
- Affiliations
- Columbia University (US)
- Addis Ababa University (ET)
- Aga Khan University (PK)
- KLE Academy of Higher Education and Research (IN)
- Gates Foundation (US)
- RTI International (US)
- Corresponding author
- Goldenberg, Robert L.
- ORCID
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2018-08-23
- Volume
- 32
- Issue
- 11
- Pages
- 1915-1923
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- PMC
- PMC6410364
- OpenAlex
- W2888163335
- Cited by
- 39
- References
- 36
- Citations by year
- 2026: 1 · 2024: 6 · 2023: 8 · 2022: 4 · 2021: 9 · 2020: 7 · 2019: 4
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- Bill and Melinda Gates Foundation
- 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 › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Keywords
- causes of death, stillbirth, neonatal death, low-middle income countries, resource-limited settings, infectious disease mortality, classification systems, diagnostic testing, data quality, research methodology
- MeSH terms
- Autopsy, Cause of Death, Developing Countries, Humans, Infant, Newborn, Stillbirth, Perinatal Death
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