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17.05.16

Calls for NHS to offer post-mortems on all stillbirths and neonatal deaths

All parents should be offered a post-mortem when their baby dies to help understand the causes of the UK perinatal death rate, a new report has recommended.

University of Leicester researchers working for research collaboration MBBRACE-UK found that in 2014, there were 4,633 extended perinatal deaths in the UK. This is a slight decrease from 4,722 in 2013, but still higher than other European countries.

The report recommends that all organisations should investigate neonatal deaths and stillbirths, instead of the 90% post-mortem rate offered at the moment.

Dr Brad Manktelow, senior lecturer at the University of Leicester, who led the statistical analysis, said: “We have used innovative statistical methods which allow us to better take into account unit size, the type of care provided and known risk factors for stillbirth and neonatal death in order to identify organisations with high mortality rates which cannot be explained just by chance alone.”

The researchers also said that all organisations with a consistently higher neonatal death rate than the national average should conduct a review of the reason why, and NHS England, NHS Scotland, NHS Wales, Health and Social Care in Northern Ireland should set targets for stillbirth and neonatal death rates.

NHS England has already set a target of reducing the stillbirth rate to 2.3 for every 1,000 by 2020.

Carmel Bagness, professional lead for midwifery & women’s health at the Royal College of Nurses, said: “Every stillbirth and neonatal loss is a tragedy, which is why it is so important to investigate these deaths for potential factors which could help prevent them, through improvements in care.”

She added that the government target must be supported by funding for specialist units, public health messaging and countering health inequalities.

Across the United Kingdom, the CCG with the highest rate of extended perinatal deaths per 1,000 births was Hull (7.07) followed by Blackburn with Darwen (7.03) and Sandwell and West Birmingham (6.96)

Public Health England recently published a report warning about ‘unacceptable’ levels of perinatal and infant deaths in the West Midlands.

In contrast, the CCGs with the lowest rates were Redbridge (4.95), Harrow and Herts Valley (5.04 each) and Enfield and Barnet (5.06 each).

Women living in areas with the highest levels of social deprivation in the UK were over 50% more likely to end in stillbirth or neonatal death compared to births from the least deprived areas of the UK. Babies of Black or Black British and Asian or Asian British ethnicity had the highest risk of extended perinatal mortality with rates of 9.9 and 8.7 per 1,000 births respectively.

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