News and Views

Report: Perinatal deaths in Ireland at ‘lowest rate’

7 Aug
Professor Richard Greene, Director of NPEC: “The most heartening aspect about this report is the amazing commitment of the busy Irish maternity units to go beyond clinical care and contribute to this national audit to help improve perinatal outcomes for mothers, babies and their families." Photo: Tomás Tyner.

The number of perinatal deaths in Ireland is at its lowest rate since recordings began, according to a new report from the National Perinatal Epidemiology Centre (NPEC), based in UCC.

 

NPEC’s report on Perinatal Mortality in Ireland (2016) found 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 (babies born with no signs of life after 24 weeks of pregnancy or weighing at least 500 grams) and neonatal deaths (deaths of live-born babies within 28 days following birth).

The perinatal mortality rate (PMR) was 5.8 deaths per 1,000 births or 1 in 172 births, representing a statistically significant decrease in the Perinatal Mortality Rate compared to 2015 (15% decrease) and the lowest PMR since recordings began. The most significant rate decrease was in early neonatal deaths.

Almost half (47.2%) of all stillbirths and 25% of early neonatal deaths were classified as severely small for gestational age. This highlights the importance of close monitoring for fetal growth during pregnancy.

Increased Body mass index (BMI) is associated with perinatal mortality. 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 in this report: compared to mothers aged between 25-29 years, women aged less than 25 years and greater than 40 years had at least twice the rate of perinatal mortality.

Perinatal mortality is an important indicator of quality of care in the Irish maternity services, and NPEC has worked with colleagues in all 19 Irish maternity units in developing an in-depth national clinical audit of perinatal mortality. The fundamental aim of this clinical audit is to improve the care of mothers and babies in Ireland through the provision of key epidemiological evidence and monitoring of adverse perinatal outcomes.

Professor Richard Greene, Director, NPEC said: “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. However, it is important that we do not 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 go beyond clinical care and 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.”

Recommendations in NPEC Perinatal Mortality Report in Ireland 2016 include the development of public health education programme on perinatal deaths and modifiable risk factors and improved antenatal detection of fetal growth restriction.

Findings include that along with the reduction in the national PMR there was less variation in the individual rates across Irish maternity units that had 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 8-28 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 was 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 was the second most common cause of death, and in the case of early neonatal death, prematurity was the second most common cause of death.

For more on this story contact:

Lynne Nolan, Media & PR Officer, UCC: 087 210 1119 or lynne.nolan@ucc.ie

Top