Salazar-Barrientos Mary, Zuleta-Tobón John Jairo
NACER, Salud Sexual y Reproductiva, Departamento de Obstetricia y Ginecología, Universidad de Antioquia, Medellín, Colombia.
Rev Colomb Obstet Ginecol. 2019 Dec;70(4):228-242. doi: 10.18597/rcog.3406.
To describe perinatal mortality in the Department of Antioquia based on the WHO International Classification of Diseases (ICD-PM) and determine the feasibility of applying this classification system to the official records on vital statistics.
Descriptive study of the causes of perinatal death according to the time of death in relation to the time of delivery and associated maternal conditions. The primary source was the official database of vital statistics for the period between 2013 and 2016. The variables measured were maternal age, gestational age and weight at the time of birth, area of residence, type of delivery, and causes of death, including direct and associated causes, and other pathological conditions. A descriptive analysis is performed, causes are presented in terms of absolute numbers and percentages, and distributed according to the timing of death in relation to childbirth and birthweight.
Of 3901 perinatal deaths occurring in fetuses 22 weeks or more of gestational age or a minimum weight of 500 g, and up to 28 days of life, 1404 (36.0%) occurred before delivery, 378 (9.7%) during the intrapartum period, 1760 (45.1%) during the neonatal period, and 359 (9.2%) cases had no information regarding the time of death in relation to the time of delivery. The main causes of death of the neonates weighing 1000 g or more were congenital malformations, deformities and chromosomal abnormalities (30.2%), antepartum and intrapartum hypoxia (29.3%), and infection (12.3%). In 69.5% of cases, no associated maternal causes were identified and in those in which there were related causes, the most frequent was placenta, cord and membrane complications (16.8%).
The ICD-PM is a system globally applicable to records of vital statistics, enabling the characterization of perinatal mortality in the Department.
根据世界卫生组织国际疾病分类（ICD-PM）描述安蒂奥基亚省的围产期死亡率，并确定将该分类系统应用于生命统计官方记录的可行性。
根据死亡时间与分娩时间的关系以及相关产妇情况对围产期死亡原因进行描述性研究。主要来源是2013年至2016年期间的生命统计官方数据库。所测量的变量包括产妇年龄、出生时的孕周和体重、居住地区、分娩类型以及死亡原因，包括直接原因和相关原因以及其他病理状况。进行描述性分析，以绝对数和百分比呈现原因，并根据死亡时间与分娩和出生体重的关系进行分布。
在孕周22周或以上或最低体重500克、出生后至28天内发生的3901例围产期死亡中，1404例（36.0%）发生在分娩前，378例（9.7%）发生在产程中，1760例（45.1%）发生在新生儿期，359例（9.2%）病例没有关于死亡时间与分娩时间关系的信息。体重1000克或以上新生儿的主要死亡原因是先天性畸形、变形和染色体异常（30.2%）、产前和产程中缺氧（29.3%）以及感染（12.3%）。在69.5%的病例中，未发现相关产妇原因，而在有相关原因的病例中，最常见的是胎盘、脐带和胎膜并发症（16.8%）。
ICD-PM是一个全球适用于生命统计记录的系统，能够对该省的围产期死亡率进行特征描述。
