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Boyd TK, Wright CA, Odendaal HJ, et al. The Stillbirth Classification System for the Safe Passage Study. Pediatr Dev Pathol. 2017;20(2):120-132doi: 10.1177/1093526616686251.
Boyd, T. K., Wright, C. A., Odendaal, H. J., Elliott, A. J., Sens, M. A., Folkerth, R. D., Roberts, D. J., Kinney, H. C. (2017). The Stillbirth Classification System for the Safe Passage Study. Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society, 20(2), 120-132. https://doi.org/10.1177/1093526616686251
Boyd, Theonia K, et al. "The Stillbirth Classification System for the Safe Passage Study." Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society vol. 20,2 (2017): 120-132. doi: https://doi.org/10.1177/1093526616686251
Boyd TK, Wright CA, Odendaal HJ, Elliott AJ, Sens MA, Folkerth RD, Roberts DJ, Kinney HC. The Stillbirth Classification System for the Safe Passage Study. Pediatr Dev Pathol. 2017 Mar-Apr;20(2):120-132. doi: 10.1177/1093526616686251. Epub 2017 Jan 26. PMID: 28326963.
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Pediatr Dev Pathol. 2017 Mar-Apr;20(2):120-132. doi: 10.1177/1093526616686251. Epub 2017 Jan 26.

The Stillbirth Classification System for the Safe Passage Study.

Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society

Theonia K Boyd, Colleen A Wright, Hein J Odendaal, Amy J Elliott, Mary Ann Sens, Rebecca D Folkerth, Drucilla J Roberts, Hannah C Kinney,

Affiliations

  1. 1 Departments of Pathology, Boston Children's Hospital, Massachusetts, USA.
  2. 2 Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  3. 3 Department of Pathology, Faculty of Medicine and Health Science, Stellenbosch University, Western Cape, South Africa.
  4. 4 National Health Laboratory Services, Port Elizabeth, South Africa.
  5. 5 Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Western Cape, South Africa.
  6. 6 Center for Health Outcomes & Prevention, Sanford Research, Department of Pediatrics & Ob-Gyn, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.
  7. 7 Department of Pathology, School of Medicine and Health Sciences, University of North Dakota, North Dakota, USA.
  8. 8 Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.

PMID: 28326963 DOI: 10.1177/1093526616686251

Abstract

Objective Describe the classification system for assigning the cause of stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD-funded Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network. The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. Methods The PASS Network classification system is based upon 5 "sites of origin" for cause of stillbirth, further subdivided into mechanism subcategories; both are employed to assign an ultimate cause of death. Each PASS stillbirth was assigned a cause of death and status of sporadic versus recurrent. Adjudication involved review of maternal and obstetrical records; fetal autopsy and placental findings; and required complete consensus in each case. Two published classification systems, ie, INCODE and ReCoDe, were used for comparison. Results Causes of stillbirth classified were fetal (26%), placental (53%), external (5%), and undetermined (16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was full agreement for cause of death across the 3 classification systems in 26% of cases and partial agreement among them in 42% of cases. Conclusions The proposed PASS schema employs a user-friendly classification that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability to perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations.

Keywords: autopsy; human fetus; placenta; prenatal alcohol exposure; prenatal cigarette smoking exposure; undetermined stillbirth

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