Abstract

It is important to examine perinatal deaths as part of a national mortality audit to identify risk factors. Implementing and re-evaluating the audit’s recommendations completes the audit cycle, preventing similar deaths in the future. In this study we examined national perinatal mortality audits’ methodology in four high-income countries (United Kingdom, New Zealand, Ireland, Netherlands) to highlight different approaches taken. We compared the recommendations made in these audits over the last five years, as well as review national initiatives addressing them. The recommendations themes included: Raising public awareness of perinatal mortality risk factors, Detection of fetal growth restriction, Prevention of preterm birth, Resources for data collection and review. Only the UK had various initiatives addressing risk factors directly. New Zealand included stakeholders in the audit recommendations’ development and provided updates on their implementation. The Netherlands developed a programme for audit recommendation implementation. Ireland created a group which is progressing some recommendations from the audit. National perinatal mortality audits are important in identifying contributory factors and making recommendations to address these. Recurring recommendations suggest a failure to resolve the identified issues. This study showed that challenges are common to high-income countries’ audits, highlighting the need for shared learning of successful initiatives.