Consistent use of the correct terms for live births, fetal deaths and infant deaths is critical for accurate documentation in the medical record, according to an updated AAP clinical report. The improved data can help ensure that these deaths are better addressed and prevented.
The report Standard Terminology for Fetal, Infant and Perinatal Deaths reviews the definitions of live birth, fetal death, infant death and perinatal death, which have not changed since the 2011 report was published. The National Center for Health Statistics of the Centers for Disease Control and Prevention defines the terms based on international standards set by the World Health Organization. The report also outlines reporting requirements for these categories.
In the past, the collection and use of information about fetal, infant and perinatal deaths have been hampered by lack of understanding of differences in definitions, statistical tabulations and reporting requirements among providers and state, national and international bodies, the report said.
Although obstetric practitioners report fetal deaths, situations can occur during delivery in which viability of the fetus or the possibility of survival is unclear. Pediatricians or neonatologists may be asked to attend the delivery to assess the medical condition of a fetus or infant; assess previable gestational age of the fetus; provide care as indicated; and report a subsequent infant death, if it occurs.
Pediatric providers, the report noted, play an important role in recording information surrounding fetal and infant deaths in the following ways:
- determining the specific vital event during delivery;
- listing information about the event on the correct certificate or report in compliance with state requirements; and
- documenting details accurately and completely, including the underlying cause of death, when known.
Complete reporting of live births, infant deaths and fetal deaths should include pertinent demographic information, maternal medical history and fetal or infant diagnoses.
The report from the AAP Committee on Fetus and Newborn is published in the May issue of Pediatrics and is available at http://dx.doi.org/10.1542/peds.2016-0551.
