2022 Key Findings

Key Findings 2022

Perinatal Mortality Rate (PMR)

For the first time, and in keeping with international practice, perinatal deaths following termination of pregnancy (TOP) are not included in the 2022 PMNCA analysis.
The perinatal mortality rate (PMR) was 5.31 per 1,000 total births in 2022. Corrected for Major Congenital Anomaly (MCA), the PMR was 3.75 per 1,000 total births. There was no statistically significant difference in PMR in 2022 compared to 2021.
The stillbirth rate associated was 3.51 per 1,000 total births and the early neonatal death rate was 1.80 per 1,000 live births.(corrected stillbirth rate was 2.69 per 1,000 total births and corrected early neonatal death rate was 1.06 per 1,000 live births).
In Ireland, a reduction in the PMR has not been achieved in the non-anomalous perinatal deaths in recent years, particularly in the case of stillbirths.
The level of variation in the rate of PMR between maternity units was higher in 2022 compared to 2021. When adjusted for MCA and in-utero transfers, one maternity unit remained an outlier as defined by NOCA policy.

Maternal characteristics

Maternal age (less than 25 and greater than 40 years) were associated with an increased risk of perinatal mortality.
While the numbers involved were small, Irish Traveller, Asian and Black ethnicities were overrepresented in the mothers who experienced perinatal deaths in 2022.
Twenty two percent (22.0%) of mothers experiencing perinatal loss booked into hospital for antenatal care before 12 weeks gestation, and more than seventy percent (70.7%) attended between 12- and 19-weeks gestation.

Infant characteristics

As in previous reports, low birthweight centiles were associated with perinatal deaths in 2022, particularly stillbirths.
An increased risk of perinatal mortality with multiple births compared to single pregnancy was again identified in 2022. Perinatal death from multiple births accounted for 11.4% of all perinatal deaths.
The rate of autopsy uptake continues to be higher in stillbirths compared to neonatal deaths.

Stillbirths

Stillbirths accounted for 66.2% of perinatal deaths in 2022.
Similar to 2021 and in contrast to previous years, specific placental conditions was the most common cause of death in stillbirths (n=73, 38.0%) followed by major congenital anomaly (n=45, 23.4%).
Intrapartum deaths accounted for 3.6% of stillbirths. This rate is lower than previous years.

Early neonatal deaths

Early neonatal deaths accounted for 33.8% of perinatal deaths in 2022.
Major congenital anomaly was the most common cause of early neonatal death (40.8%) followed by Respiratory disorders (25.5%), primarily due to severe pulmonary immaturity.
More than half (59.2%) of early neonatal deaths occurred within 24 hours of delivery.

Late neonatal deaths

There were 40 late neonatal deaths reported to the NPEC in 2021.
Major congenital anomaly was the most cause of late neonatal death (32.5%) followed by Respiratory disorders (17.5%)
In contrast to previous reports, the proportion of late neonatal deaths was found to increase across the second and third weeks of life in 2021 (i.e., 42.5% in week two and 57.5% in week three).

Early neonatal deaths with a birthweight <500g and a gestational age at delivery <24 weeks

There were 35 early neonatal deaths with a birthweight < 500g and a gestational age at delivery < 24 weeks excluding deaths following TOPs in 2022.
The majority of the 35 deaths occurred in babies delivered less than 22 weeks (94.3%) with 2 deaths occurring after 22 weeks.
The assigned neonatal cause of death was pre-viable for the majority of cases (68.6%) followed by severe pulmonary immaturity (22.9%)