Island of Ireland Perinatal Mortality Report 2014 and 2015

The National Perinatal Epidemiology Centre (NPEC), in collaboration with Northern Ireland Maternal and Child Health office (NIMACH), publishes: Island of Ireland Perinatal Mortality Report 2014 and 2015.

This is the first report on perinatal mortality occurring across the Island of Ireland. Comparative data is included on perinatal deaths in the Republic of Ireland (ROI) and Northern Ireland (NI) arising from live births and stillbirths that occurred in the combined years 2014 and 2015 with a gestational age of 24 weeks or more. Anonymised data from all maternity units was collated and analysed by the NPEC in the ROI and by the NIMACH in NI.

Findings: There were 182,600 births that were less than 24 weeks gestational age at delivery across the Island of Ireland in 2014-2015. Stillbirths and early neonatal deaths accounted for 753 (66.3%) and 383 (33.7%) of 1,136 perinatal deaths respectively. A further 81 late neonatal deaths occurred. The 2014 and 2015 perinatal mortality rate (PMR) for the ROI and NI were similar. The All-Ireland perinatal mortality rate was 6.2 deaths per 1,000 births; adjusted to exclude perinatal deaths due to congenital anomaly, the rate was 3.85 per 1,000 births. The 2014 and 2015 stillbirth rate for the ROI was 4.35 per 1,000 births as compared to a rate of 3.50 per 1,000 births for NI. In contrast the neonatal mortality rate in the ROI was lower, at 2.39 per 1,000 live births, compared to NI, at 3.00 per 1,000 live births. The differences in both stillbirth and neonatal death rates between the ROI and NI was found to be statistically significant. Major congenital anomaly was the primary cause of perinatal death in both the ROI and NI; present in 24.3% and 63.6% of all stillbirths and neonatal deaths respectively. The distribution of customised birth weight centiles was similar in the ROI and NI. Approximately 40% of perinatal deaths were severely small for gestational age. Across the Island of Ireland, a post-mortem examination was undertaken more often in stillbirths than in neonatal deaths in 2014 and 2015 - 54% of stillbirths and 40% of neonatal deaths in the ROI and 70% of stillbirths and 33% of neonatal deaths in NI.

Key recommendations:

  • Establish a process for biennial reporting on perinatal mortality for the Island of Ireland as a resource to support service improvement, audit and benchmarking.
  • Improve awareness among professionals of the impact of fetal growth restriction on perinatal mortality.
  • The generation of customised birth weight centile charts for every woman during pregnancy should be considered. A post mortem examination carried out by a specialist pathologist should be offered for all perinatal deaths.

This is the first assessment of Perinatal Mortality across the Island of Ireland. Similarities in factors associated with perinatal death occurring in ROI and NI illustrates the importance of working in a collaborative way in order that we can learn and work together to reduce avoidable perinatal mortality in the future.We would like to extend our sincere thanks to all the contributors and health careprofessionals across the Island of Ireland for providing data to both the NPEC and NIMACH. This report would not be possible without their support and cooperationIsland of Ireland Perinatal Mortality Report 2014 and 2015.

Island of Ireland Perinatal Mortality 2014-2015 Report

Island of Ireland Perinatal Mortality 2014-2015 Infographic

National Perinatal Epidemiology Centre

Dept. of Obstetrics and Gynaecology, 5th Floor, Cork University Maternity Hospital, Wilton, Cork

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