全球范围内使用国际围产儿死亡分类（ICD-PM）：系统评价。
The global use of the International Classification of Diseases to Perinatal Mortality (ICD-PM): A systematic review.
机构信息
Department of Obstetrics, Division Women and Baby, Birth Centre Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
Department of Obstetrics and Gynaecology, Academic Hospital Paramaribo (AZP), Paramaribo, Suriname.
出版信息
J Glob Health. 2022 Aug 17;12:04069. doi: 10.7189/jogh.12.04069.
BACKGROUND
The World Health Organization launched the International Classification of Diseases for Perinatal Mortality (ICD-PM) in 2016 to uniformly report on the causes of perinatal deaths. In this systematic review, we aim to describe the global use of the ICD-PM by reporting causes of perinatal mortality and summarizing challenges and suggested amendments.
METHODS
We systematically searched MEDLINE, Embase, Global Health, and CINAHL databases using key terms related to perinatal mortality and the classification for causes of death. We included studies that applied the ICD-PM and were published between January 2016 and June 2021. The ICD-PM data were extracted and a qualitative analysis was performed to summarize the challenges of the ICD-PM. We applied the PRISMA guidelines, registered our protocol at PROSPERO [CRD42020203466], and used the Appraisal tool for Cross-Sectional Studies (AXIS) as a framework to evaluate the quality of evidence.
RESULTS
The search retrieved 6599 reports. Of these, we included 15 studies that applied the ICD-PM to 44 900 perinatal deaths. Most causes varied widely; for example, "antepartum hypoxia" was the cause of stillbirths in 0% to 46% (median = 12%, n = 95) in low-income settings, 0% to 62% (median = 6%, n = 1159) in middle-income settings and 0% to 55% (median = 5%, n = 249) in high-income settings. Five studies reported challenges and suggested amendments to the ICD-PM. The most frequently reported challenges included the high proportion of antepartum deaths of unspecified cause (five studies), the inability to determine the cause of death when the timing of death is unknown (three studies), and the challenge of assigning one cause in case of multiple contributing conditions (three studies).
CONCLUSIONS
The ICD-PM is increasingly being used across the globe and gives health care providers insight into the causes of perinatal death in different settings. However, there is wide variation in reported causes of perinatal death across comparable settings, which suggests that the ICD-PM is applied inconsistently. We summarized the suggested amendments and made additional recommendations to improve the use of the ICD-PM and help strengthen its consistency.
REGISTRATION
PROSPERO [CRD42020203466].
背景
世界卫生组织于 2016 年推出了《国际围产儿死亡分类》（ICD-PM），以统一报告围产儿死亡的原因。在这项系统评价中，我们旨在通过报告围产儿死亡的原因来描述全球对 ICD-PM 的使用情况，并总结挑战和建议的修订。
方法
我们使用与围产儿死亡率和死因分类相关的关键词，系统地检索了 MEDLINE、Embase、全球卫生和 CINAHL 数据库。我们纳入了应用 ICD-PM 并于 2016 年 1 月至 2021 年 6 月间发表的研究。提取 ICD-PM 数据，并进行定性分析以总结 ICD-PM 的挑战。我们应用了 PRISMA 指南，在 PROSPERO[CRD42020203466]上注册了我们的方案，并使用横断面研究评估工具（AXIS）作为评估证据质量的框架。
结果
检索到 6599 份报告。其中，我们纳入了 15 项研究，这些研究应用 ICD-PM 对 44900 例围产儿死亡进行了分析。大多数死因差异很大；例如，在低收入环境中，“产前缺氧”是死产的原因，占 0%至 46%（中位数=12%，n=95），在中等收入环境中占 0%至 62%（中位数=6%，n=1159），在高收入环境中占 0%至 55%（中位数=5%，n=249）。有五份研究报告了 ICD-PM 的挑战和建议修订。报告最多的挑战包括产前死因不明的比例较高（五项研究），当死亡时间未知时无法确定死因（三项研究），以及在存在多种致病条件时确定单一死因的挑战（三项研究）。
结论
ICD-PM 在全球范围内的应用越来越广泛，使医疗保健提供者深入了解不同环境下围产儿死亡的原因。然而，在可比环境中报告的围产儿死亡原因存在广泛差异，这表明 ICD-PM 的应用不一致。我们总结了建议的修订，并提出了额外的建议，以改善 ICD-PM 的使用，并帮助加强其一致性。
登记
PROSPERO[CRD42020203466]。
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