Assessment of risk of perinatal death in Jamaica

ABSTRACT

Data from the Jamaican Perinatal Mortality Survey had been used to create a statistical model using logistic regression. From this a simple additive scoring system to predict perinatal death was devised and tested on the 2 cohort months of the study. The score had a theoretical range of 0-28 points, with the higher the score, the greater the likelihood of a perinatal death. For a cut-point of 7 sensitivity was 43 percent and specificity 84 percent. A cut-point of 8 resulted in 27 percent sensitivity and 94 percent specificity. Higher cut-points resulted in much reduced sensitivity but enhanced specificity (e.g. cut-point 10 11 percent sensitivity, 99 percent specificity). However, it is likely that these estimates are optimistically high, and to achieve unbiased estimates of sensitivity and specificity the score needs to be tested on a sample of the population from which it was not derived before implementation takes place. Meanwhile, the cut-off level for implementation will depend on appropriate resources available (Summary)