Article type
Year
Abstract
Background:
Expert opinion favours the separate reporting of stillbirth and neonatal death in favour of (or as well as) the combined measure of perinatal mortality. Stillbirths and early neonatal deaths now often differ substantially with respect to their principal known or suspected causes; in high-income countries in particular, aetiological differences exist. While a presentation at the 2010 Cochrane Colloquium highlighted this need for “clearer reporting of perinatal deaths in Cochrane Reviews . . . particularly separate reporting of fetal and neonatal deaths . . . ” progress towards this goal is unknown.
Objectives:
To review recent approaches to the reporting of perinatal mortality, fetal and neonatal death in Cochrane Reviews, and to assess the utility of the reviews for identifying promising interventions.
Methods:
We reviewed new intervention reviews published by the Pregnancy and Childbirth Group in 2012 to 2013, assessing the inclusion of pre-specified primary and secondary review outcomes relating to perinatal mortality, and the separate reporting of its components; we also reviewed reporting of outcome data by included trials.
Results: 50 of the 74 reviews included pre-specified review outcomes relating to stillbirth and/or neonatal death; 31 pre-specified a primary review outcome (perinatal mortality was the most common). Only one-third of the reviews pre-specified separate components of perinatal death as outcomes. For almost half of the reviews (24/50) there were no data reported by trials for these outcomes; where data were reported, reviews were unable to confirm or refute reductions in deaths due to insufficient trials or participants.
Conclusions:
A more consistent approach to the reporting of perinatal mortality in Cochrane Reviews is required – particularly the separate reporting of fetal and neonatal death, and the standardisation of review and trial outcome definitions. While Cochrane Reviews are essential for assessing promising interventions for reducing perinatal mortality (and recognise this through pre-specification of outcomes), their ability to do so is often compromised by deaths not being reported in trials.
Expert opinion favours the separate reporting of stillbirth and neonatal death in favour of (or as well as) the combined measure of perinatal mortality. Stillbirths and early neonatal deaths now often differ substantially with respect to their principal known or suspected causes; in high-income countries in particular, aetiological differences exist. While a presentation at the 2010 Cochrane Colloquium highlighted this need for “clearer reporting of perinatal deaths in Cochrane Reviews . . . particularly separate reporting of fetal and neonatal deaths . . . ” progress towards this goal is unknown.
Objectives:
To review recent approaches to the reporting of perinatal mortality, fetal and neonatal death in Cochrane Reviews, and to assess the utility of the reviews for identifying promising interventions.
Methods:
We reviewed new intervention reviews published by the Pregnancy and Childbirth Group in 2012 to 2013, assessing the inclusion of pre-specified primary and secondary review outcomes relating to perinatal mortality, and the separate reporting of its components; we also reviewed reporting of outcome data by included trials.
Results: 50 of the 74 reviews included pre-specified review outcomes relating to stillbirth and/or neonatal death; 31 pre-specified a primary review outcome (perinatal mortality was the most common). Only one-third of the reviews pre-specified separate components of perinatal death as outcomes. For almost half of the reviews (24/50) there were no data reported by trials for these outcomes; where data were reported, reviews were unable to confirm or refute reductions in deaths due to insufficient trials or participants.
Conclusions:
A more consistent approach to the reporting of perinatal mortality in Cochrane Reviews is required – particularly the separate reporting of fetal and neonatal death, and the standardisation of review and trial outcome definitions. While Cochrane Reviews are essential for assessing promising interventions for reducing perinatal mortality (and recognise this through pre-specification of outcomes), their ability to do so is often compromised by deaths not being reported in trials.