Infant mortality: Development of a proposed update to the dollfus classification of infant deaths

Ann M. Nakamura, Melanie S. Dove, Archana Minnal, Mark Damesyn, Michael P. Curtis

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective. Identifying infant deaths with common underlying causes and potential intervention points is critical to infant mortality surveillance and the development of prevention strategies. We constructed an International Classifi­cation of Diseases 10th Revision (ICD-10) parallel to the Dollfus cause-of-death classification scheme first published in 1990, which organized infant deaths by etiology and their amenability to prevention efforts. Methods. Infant death records for 1996, dual-coded to the ICD Ninth Revision (ICD-9) and ICD-10, were obtained from the CDC public-use multiple-cause-of-death file on comparability between ICD-9 and ICD-10. We used the underlying cause of death to group 27,821 infant deaths into the nine categories of the ICD-9-based update to Dollfus’ original coding scheme, published by Sowards in 1999. Comparability ratios were computed to measure concordance between ICD versions. Results. The Dollfus classification system updated with ICD-10 codes had limited agreement with the 1999 modified classification system. Although prematurity, congenital malformations, Sudden Infant Death Syndrome, and obstetric conditions were the first through fourth most common causes of infant death under both systems, most comparability ratios were significantly different from one system to the other. Conclusion. The Dollfus classification system can be adapted for use with ICD-10 codes to create a comprehensive, etiology-based profile of infant deaths. The potential benefits of using Dollfus logic to guide perinatal mortality reduction strategies, particularly to maternal and child health programs and other initiatives focused on improving infant health, warrant further examination of this method’s use in perinatal mortality surveillance.

Original languageEnglish (US)
Pages (from-to)632-642
Number of pages11
JournalPublic Health Reports
Issue number6
StatePublished - Nov 2015
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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