A systematic review of standardised tools used in perinatal death review programmes

Our review found that there is little standardisation when it comes to perinatal mortality review tools. Guidance on structuring such tools in a standardised way is needed as part of efforts to reduce preventable perinatal deaths.


Emily O'Connor, Sara Leitao, Amy Fogarty, Keelin O'Donoghue

Journal Name
Women and Birth
Journal Article
Audit / Service evaluation, Neonatal death, Perinatal mortality, Stillbirth


Full Citation

O'Connor E, Leitao S, Fogarty A, Greene RA, O'Donoghue K. A systematic review of standardised tools used in perinatal death review programmes. Women and Birth. 2024;37(1):88-97.

Link to Publication


Reducing preventable baby deaths is an important focus of systems in countries that report and monitor these deaths. Review programmes into baby deaths can use a tool (this might be called a perinatal mortality review tool or PMRT) to review all aspects of care in that pregnancy and around birth, to identify preventable factors in the death and to develop recommendations for improvements to clinical care to prevent future baby deaths. We conducted an analysis of standardised baby death review tools (PMRTs) used in review programmes in different countries internationally and compared them to each other.

Ten PMRTs were identified and included: five from high-income countries, four from upper-middle income countries, and one was designed for use in a global context. The structure, content, and quality of each PMRT varied. Each tool collected information about the pregnancies, labour and birth and reviewed the care provided as well as care of the baby. Five included recommendation development for changes to clinical care. Only four mentioned parent involvement in the review process.  When we looked at the quality of the PMRTs available, using a structured approach, one tool scored “high quality”, six scored “moderate quality” and two scored “poor quality”. There is little standardisation when it comes to PMRTs. Guidance on structuring PMRTs in a standardised way is needed.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,