Posted 21 July 2010 by Maura O'Malley
The perinatal mortality and stillbirth rate continue
to fall across the UK, concludes a new report from the Centre for Maternal and
Child Enquiries (CMACE).
The perinatal mortality rate has fallen from 8.3 per 1000
total births in 2000 to 7.5 per 1000 in 2008.
The stillbirth rate has also fallen – from 5.4 in 2000 to
5.1 in 2008 per 1000 live births.
However, there was wide variation in rates across the
regions. The East of England had the lowest number of stillbirths (3.8 per 1000 live births), while the north
east of England had the highest (5.4 per 1000 live births).
For neonatal deaths, the south-east coast had the lowest
rate (2.4 per 1000 live births) and the West Midlands had the highest (3.7 per
1000 live births).
The authors note that it is unclear why some regions have a
higher perinatal mortality rate over others. Possible reasons include reporting
differences and variations in the risk profiles of women and babies cared for.
Socio-demographic trends from the data collected showed that
the incidence of stillbirths and neonatal deaths is higher in women under 25 and women over 40.
Furthermore, mothers living in the most deprived areas of the country were 1.7
times more likely to have a stillbirth and over twice as likely to have a neonatal
death compared to women in the least deprived areas.
Black women were over twice as likely to have a stillbirth
and neonatal death than white
women.
The report also marks the use of a new classification system
to record all conditions that arose during the pregnancy that was caused or was
associated with death. In previous reports, 50% of stillbirths were classified
as ‘unexplained’, using the Wigglesworth and Obstetric (Aberdeen)
Classifications, the figure has fallen to 23% by collecting more details on
factors associated with death such as intrauterine growth restriction.
The new classification system shows that in 13% of
stillbirths antepartum or intrapartum haemorrhage was the cause or was
associated with death, 10% were linked to intrauterine growth restriction and 9% were linked with specific placental conditions.
In addition, a quarter of mothers who had a stillbirth or
neonatal death had a body mass index of 30 or more and a fifth of stillbirths
and neonatal deaths occurred in mothers who smoked during pregnancy.
The deputy general secretary of the RCM Louise Silverton
said: 'Stillbirths and the death of babies are devastating for the parents and
families affected, so the improvements we are seeing are very welcome,
encouraging and show that things are moving in the right direction.’
She added: ‘The
regional variations are a real concern and we need to pin down what is causing
this. The report also highlights one of the real tragedies of health
inequalities, that those in the most deprived areas are adversely affected.
There is a pressing need to focus on this and bridge the gap between the best
and worst off in our society.
‘This is a positive report but we cannot rest on our
laurels, because there is much more to be done, and more improvements to be
made. There is also a real need to ensure that impending savings that have to
be made in the NHS do not effect the care and allocation of resources that is
driving these rates down; that would be a tragedy.
’In particular, recent improvements in midwifery staffing
levels must be continued in order to ensure optimum outcomes for all births.
Click here to view the report Perinatal mortality report 2008.
