Perinatal Death Surveillance and Response

Investigating and Reducing Stillbirths and Neonatal Deaths

As many as 3 million stillbirth and newborn deaths could be prevented each year if skilled delivery and resuscitation care were available for all births, and if high-risk births were identified early. In low resource countries; however, this medical care may be lacking. In addition, these countries may have incomplete reporting, surveillance, and death registration systems; one of the purposes of perinatal death surveillance systems is to identify and monitor the number and characteristics of perinatal deaths (i.e., deaths that occur around the time of birth).

The Perinatal Death Surveillance and Response system follows the same framework as the Maternal Death Surveillance and Response (MDSR). As with MDSR, CDC has collaborated with WHO to develop PDSR guidance for countries to adapt and use.

CDC provides technical assistance to countries to set up or improve systems to identify, notify, and review stillbirths and neonatal deaths in health facilities and in communities in high mortality settings. CDC has worked in several countries, evaluating their existing death surveillance systems and helping them to:

• Monitor all pregnancy outcomes (live births, stillbirths, newborn deaths) and the care they received, and document all stillbirth and newborn deaths.
• Strengthen the system of perinatal reviews to include all stillbirths and pre-discharge newborn deaths.
• Adapt PDSR guidelines to fit their setting.
• Assess and interpret the PDSR data to guide improvements in surveillance and medical care.

CDC’s assistance with PDSR includes:

• Evaluating the surveillance system set up in Uganda as part of the Saving Mothers, Giving Life initiative (SMGL), and training and guiding staff to improve the system’s efficiency. This included introducing a verbal and social autopsy developed in collaboration with WHO.
• Training staff in Zambia (also as part of SMGL) to conduct perinatal death surveillance, including conducting cause-of-death analyses.
• Improving perinatal death reporting in Uganda and Cameroon and developing national surveillance guidelines.
• Conducting surveillance of all stillbirths and newborn deaths in health facilities in Kigoma Region, Tanzania  from 2013 through 2019.