Assessment of risk of perinatal death in Jamaica

Abstract

Summary. Data from the Jamaican Perinatal Mortality Survey had been used to create a statistical model using logistic regression.1 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% and specificity 84%. A cut‐point of 8 resulted in 27% sensitivity and 94% specificity. Higher cut‐points resulted in much reduced sensitivity but enhanced specificity (e.g. cut‐point 10: 11% sensitivity, 99% 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. Copyright © 1994, Wiley Blackwell. All rights reserved