Perinatal death rate at lowest since records began
The number of perinatal deaths in Ireland is at its low-est since recordings began. The majority involve overweight or obese mothers, according to a new study.
A report covering 2016 from the National Perinatal Epidemiology Centre (NPEC) at UCC also finds that low birthweight is associated with perinatal death, which refers to the death of babies in the weeks before or after birth and includes stillbirths.
The perinatal mortality rate (PMR), regarded as an important indicator of the quality of care in Irish maternity services, is 5.8 deaths per 1,000 births or one in 172 births. These figures represent a 15% decrease compared to 2015 and the lowest PMR since recordings began.
The most significant rate decrease is in early neonatal deaths.
Almost half (47.2%) of all stillbirths and 25% of early neonatal deaths are classified as severely small for gestational age.
Increased body mass index (BMI) is associated with perinatal mortality,” notes the report.
“Over half (56.6%) of the mothers who experienced perinatal loss in 2016 were either overweight or obese.”
An association between maternal age and perinatal mortality was also identified by researchers in the report. Compared to mothers aged between 25 and 29, women aged less than 25 and who were more than 40 years of age had at least twice the rate of perinatal mortality.
“It is wonderful to see the clear reduction in perinatal mortality described in this report. While this finding is just one for one year, we would hope that this trend continues in the future,” said Professor Richard Greene, director of NPEC.
Prof Greene said, however, that it is important not to focus on rates and numbers alone: “We should remember that each perinatal death has a profound effect on a mother, a father, and the extended family.
The most heartening aspect about this report is the amazing commitment of the busy Irish maternity units to contribute to this national audit to help improve perinatal outcomes for mothers, babies, and their families. The maternity services are leaders in the area of clinical review and audit.
The report shows that, along with the reduction in the national PMR, there is less variation in the individual rates across Irish maternity units than has been observed in previous years.
In 2016, 407 perinatal deaths occurred amongst 64,133 births. Stillbirths, deaths within the first seven days of life (early neonatal deaths), and deaths within the first eight to 28 days of life (late neonatal deaths) accounted for 250 (61.4%), 124 (30.5%), and 33 (8.1%) of the 407 deaths respectively.
Similar to recent years, major congenital anomaly is the most common cause of perinatal death, being the primary cause of death in 31.2% of stillbirths, 54.8% of early neonatal deaths, and 45.4% of late neonatal deaths.
In the case of stillbirths, placental disease is the second most common cause of death, and in the case of early neonatal death, prematurity is the second most common cause of death.
Recommendations in ‘NPEC Perinatal Mortality Report in Ireland 2016’ include the development of public health education programmes on perinatal deaths and modifiable risk factors and improved antenatal detection of fetal growth restriction.
