Perinatal Mortality in Ireland Annual Report 2016
The National Perinatal Epidemiology Centre publishes Perinatal Mortality in Ireland Annual Report 2016.
A total of 407 perinatal deaths in 2016 were recorded, arising from 64,133 births of at least 24 weeks gestation or at least 500 grams in birthweight. Stillbirths, early neonatal and late neonatal deaths accounted for 250 (61.4%), 124 (30.5%) and 33 (8.1%) of the 407 deaths, respectively.The perinatal mortality rate (PMR) was 5.8 deaths per 1,000 births or 1 in 172 births. Corrected to exclude deaths due to major congenital anomaly, the PMR was 3.6 per 1,000 births.
A statistically significant decrease in the PMR was recorded in 2016 compared to 2015 (15% decrease). The 2016 rate also represents the lowest PMR since recordings began. The most significant rate decrease was in early neonatal deaths. Along with the reduction in the national PMR, there was less variation in the individual rates across Irish maternity units than that observed in previous years.Major congenital anomaly remains the main cause of death of stillbirth, early neonatal death and late neonatal death.Fetal growth restriction continues to appear as a significant associated factor with perinatal mortality. Improved antenatal detection is a potentially modifiable factor.
Key recommendations from the 2016 report include:
- Improved antenatal detection of fetal growth restriction (FGR) with timely delivery is a preventative strategy to reduce perinatal mortality. NPEC recommends a national standardised approach be adapted by all units in the detection of FGR, and outlines methodologies to be considered.
- A public health education programme on perinatal deaths and modifiable risk factors should be developed.
- Further research exploring factors impacting on autopsy rates is warranted.
- Funding should be provided by the Health Service Executive to ensure that staffing levels allow protected time for clinical audit.NPEC gratefully acknowledges the midwives, obstetricians, paediatricians, pathologists and administration staff who have contributed data to this audit. This report would not be possible without their dedicated support and co-operation.