National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland; Pregnancy Loss Research Group, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.
National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland; Pregnancy Loss Research Group, University College Cork, Cork, Ireland.
Eur J Obstet Gynecol Reprod Biol. 2021 Dec;267:111-119. doi: 10.1016/j.ejogrb.2021.10.012. Epub 2021 Oct 30.
It is important to examine perinatal deaths as part of a national mortality audit to identify risk factors. Implementing and re-evaluating recommendations from perinatal mortality audits completes the audit cycle, preventing similar deaths in the future. Lack of implementation results in recommendations recurring.
In this study we examine national perinatal mortality audits' methodology in four high-income countries (United Kingdom, New Zealand, Ireland, Netherlands) to highlight different approaches taken. We compare the recommendations made in these audits' reports over the last five years, as well as review national initiatives and programmes addressing them.
This study is an integrative review where two comprehensive literature searches were completed: on established national perinatal mortality audits in high-income countries; and on national initiatives addressing recommendations from these audits. Content analysis of the audits' recommendations was performed organising them into themes according to topics these focused on.
Though the methodology of the national perinatal mortality audits varied, all four were state-funded and had standardised online data collection forms to report deaths. The recommendations themes included: Raising public awareness of perinatal mortality risk factors, Detection of fetal growth restriction, Prevention of preterm birth, Resources for data collection and review. Only the UK had various initiatives addressing perinatal mortality risk factors directly. New Zealand included stakeholders in the audit recommendations' development and provided updates on their implementation. The Netherlands developed a programme for audit recommendation implementation. Ireland created a group which is progressing some recommendations from the audit.
National perinatal mortality audits are important in identifying contributory factors and making recommendations to address these. Recurring recommendations suggest a failure to resolve the identified issues. This study shows how some challenges are common to high-income countries' audits, highlighting the need for shared learning of successful initiatives.
作为国家死亡率审核的一部分，检查围产期死亡非常重要，以确定风险因素。实施和重新评估围产期死亡率审核的建议完成了审核周期，防止未来发生类似的死亡。建议未得到实施会导致其反复出现。
在这项研究中，我们检查了四个高收入国家（英国、新西兰、爱尔兰、荷兰）的国家围产期死亡率审核的方法，以突出所采用的不同方法。我们比较了这些审核报告在过去五年中提出的建议，并审查了针对这些建议的国家倡议和方案。
这是一项综合审查，完成了两次全面的文献搜索：一次是针对高收入国家已建立的国家围产期死亡率审核；另一次是针对解决这些审核建议的国家倡议。对审核建议进行内容分析，根据这些建议所关注的主题将其组织成主题。
尽管国家围产期死亡率审核的方法有所不同，但所有四个国家的审核都是由国家资助的，并使用标准化的在线数据收集表格来报告死亡。建议的主题包括：提高公众对围产期死亡风险因素的认识、胎儿生长受限的检测、早产的预防、数据收集和审查资源。只有英国有各种直接针对围产期死亡风险因素的倡议。新西兰让利益攸关方参与审核建议的制定，并提供有关实施情况的最新信息。荷兰为审核建议的实施制定了一项方案。爱尔兰成立了一个小组，正在推进审核中的一些建议。
国家围产期死亡率审核对于确定促成因素并提出解决这些问题的建议非常重要。反复出现的建议表明，确定的问题尚未得到解决。本研究表明，一些高收入国家审核所面临的挑战是共同的，突出了需要共享成功倡议的学习经验。
