A clinico-pathological classification of perinatal deaths in the Faroe Islands.

OBJECTIVE

To highlight the causes of perinatal mortality in the Faroe Islands where perimortality is high according to Nordic standards.

DESIGN

Two systems were employed to classify perinatal deaths on the basis of clinico-pathological findings, one focusing on obstetrical factors and the other on fetal-neonatal factors.

SETTING

Faroe Islands. Data from Iceland were used for comparison since the two communities have many similarities, including similar birthweight distributions.

SUBJECTS

Birth and death certificates and medical and midwife files were recovered for 98 of the 102 officially recorded perinatal deaths in the Faroes during 1977-1986. Icelandic data for 1976-1985 were available in the literature.

RESULTS

The perinatal mortality rate was 13.7 per 1000 births. Obstetric factors were classified as unexplained, congenital anomaly, antepartum haemorrhage, pre-eclampsia, mechanical causes, and maternal disorders and accounted for 43%, 18%, 15%, 11%, 6% and 6% of the 98 cases, respectively. Fetal-neonatal factors were classified as antepartum asphyxia, congenital anomaly, intrapartum asphyxia, hyaline membrane disease, pulmonary immaturity, and other causes, and these factors accounted for 43%, 18%, 15%, 9%, 5%, and 8%, respectively. The excess perinatal mortality rate of 4.1 cases per 1000 births in the Faroes, relative to Iceland, could mainly be attributed to an excess of 2.9 cases per 1000 births in the group classified as unexplained, as defined according to the obstetrics classification.

CONCLUSIONS

No well defined cause was particularly common in the Faroes or could account for the excess perinatal mortality rate in the Faroes relative to Iceland.