BMJ  2005;331:1269 (26 November), doi:10.1136/bmj.331.7527.1269-c

Letter

Classification of stillbirth

Reclassification obscures things

The first 150 words of the full text of this article appear below.

EDITOR—Gardosi et al say that any classification system that results in a high proportion of cases being defined as unexplained is not fulfilling its purpose.1 If it is true, however, that the mechanism or cause leading to death in an individual case cannot be determined with more than speculative certainty, it is entirely correct to classify the case as unexplained rather than to assign a potentially erroneous or artificial cause of death in order to create the impression of knowledge.

The main finding of this study is the reclassification of numerous apparently previously unexplained cases as fetal growth restriction, such classification being on the basis of an estimated customised weight for gestation below the 10th centile. The clinical relevance of growth restriction according to these criteria remains controversial in ongoing pregnancies, and therefore to attribute the cause of death to fetal growth restriction in the absence of other . . . [Full text of this article]

Neil J Sebire, consultant in paediatric pathology

Great Ormond Street Hospital, London WC1N 3JH
sebirn@gosh.nhs.uk


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Relevant Article

Classification of stillbirth by relevant condition at death (ReCoDe): population based cohort study
Jason Gardosi, Sue M Kady, Pat McGeown, Andre Francis, and Ann Tonks
BMJ 2005 331: 1113-1117. [Abstract] [Full Text] [PDF]

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