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Errors in the certification of neonatal death
Author(s) -
Hunt R,
Barr P
Publication year - 2000
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2000.00556.x
Subject(s) - medicine , cause of death , death certificate , autopsy , neonatal death , pathological , pediatrics , coroner , birth certificate , medical emergency , injury prevention , pregnancy , poison control , disease , population , fetus , environmental health , biology , genetics
Objective : To examine the precision of the perinatal death certificate (PDC) and ascertain the possible sources of error in the certification of neonatal deaths. Methods : The ‘Main’ and ‘Other’ causes of death recorded on the PDC were obtained from the Registry of Births, Deaths and Marriages and compared with those from a clinicopathological summary (CPS) completed after all pending laboratory results and/or autopsy information were available. Results : There were 179 neonatal deaths during the 7 year period under review. The PDC and CPS main causes of death were concordant in 103 of 179 infants (58%) and discordant in the remaining 76 infants (42%). The PDC main cause of death was incorrectly classified in 61 of 76 infants (80%) with discordant findings and was incompletely classified in the remaining 15 infants (20%). The following discordancies were recorded for the 61 infants with an incorrect classification: (i) transposition of the ‘Main’ and ‘Other’ causes of death, resulting in a sequencing discordancy in 14 infants (23%); (ii) recording a non‐pathological condition as the main cause of death in 40 infants (66%); and (iii) recording an incorrect pathological condition as the main cause of death in seven infants (11%). Eight of the 61 (13%) incorrect classifications and four of the 15 (27%) incomplete classifications were associated with laboratory and/or autopsy data being unavailable when the PDC was completed. Conclusions : The concordancy between the PDC and CPS would have increased from 58 to 91% if the ‘Main’ and ‘Other’ causes of death had been sequenced correctly, if the main cause of death had been ascribed to a pathological disease rather than a non‐pathological condition and if corrective information from pending laboratory tests and/or autopsy examination had been made available to the Registry of Births, Deaths and Marriages.