Scottish Perinatal and Infant Mortality and Morbidity Report 2010

The Scottish Perinatal and Infant Mortality and Morbidity Report (SPIMMR) is published annually. The Scottish Stillbirth and Infant Death Survey (SSBIDS) and the production of the report are managed jointly by the Reproductive Health Programme of Healthcare Improvement Scotland and the Information Services Division (ISD) of NHS National Services Scotland with collaboration from the National Records of Scotland (NRS).

The report includes information on rates, causes and associated factors for stillbirths, neonatal deaths (babies up to four weeks of age), post-neonatal infant deaths (four weeks to 12 months old) and late fetal deaths (pregnancy losses from 20 to 23+6 weeks gestation). The incidence of certain specified congenital anomalies is also reported.

Key Points

Rates of stillbirths and deaths: Lowest ever recorded stillbirth rate in Scotland

The rates of stillbirths, neonatal deaths and infant deaths (all deaths in the first year) were the lowest ever recorded in Scotland as was the perinatal mortality rate (stillbirths plus deaths in the first week of life). The rate of post-neonatal deaths equalled the lowest ever recorded.

• Stillbirth rate 4.9 per 1000 births
• Neonatal death rate 2.6 per 1000 live births
• Perinatal mortality rate 6.9 per 1000 births
• Post-neonatal deaths 1.2 per 1000 live births
• Infant mortality rate 3.7 per 1000 live births

Total births and deaths in 2010:

There were 59,082 births, 281 fewer than in 2009, reversing the steady rise since 2002. A total of 661 deaths were notified to the SSBIDS, comprising 152 late fetal deaths, 291 stillbirths, 150 neonatal deaths and 68 post-neonatal deaths.

Causes of stillbirths and neonatal deaths:

The most frequent identifiable causes of stillbirth were antepartum haemorrhage (bleeding in pregnancy) and congenital abnormality of the baby but 62% had no obvious explanation. Examination of the placenta, however, showed an abnormality in 62% of these “unexplained” stillbirths and 29% of these babies had evidence of poor growth in the womb.

Prematurity was the most common problem associated with neonatal deaths, accounting for 33% while congenital abnormality caused 23% of neonatal deaths.

Other findings:

• The postmortem rate for stillbirths rose to 63% from 59% in 2009.
• The placenta was examined histologically in 80% of stillbirths.
• There is an association between obesity and stillbirth and between infant death and smoking and deprivation.
• Antenatal screening reduces the rates of neural tube defects and Down's syndrome at birth.

NHS Board variations:

Variations in the rates of stillbirths and neonatal deaths between NHS Boards are likely to be related to random variation and to differing registration practices. Possible additional reasons for an increased stillbirth rate in one board area are being investigated.

Commentary:

Commentary is provided on some of the factors which may have contributed to a fall in all death rates. Further improvements to neonatal death registration, data collection, death classification and reporting are also discussed and form the basis of some of the recommendations.

Published Date: 31 January 2012