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MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) have published their latest Perinatal Mortality Surveillance Report. This gives an overview of baby deaths in the UK for babies born January to December 2018. The MBRRACE-UK perinatal team based at the University of Leicester is part of the MBRRACE-UK collaboration led from the National Perinatal Epidemiology Unit (NPEU) within NDPH. The collaboration works to provide data that helps healthcare commissioners and professionals to identify effective strategies to reduce preventable baby deaths.

Overall, the report shows that baby deaths have steadily decreased in the UK over the past five years:

  • Total baby deaths in the UK reduced by 15% over five years, from 6.04 per 1,000 total births in 2013 to 5.13 per 1,000 total births in 2018. This is equivalent to 670 fewer baby deaths in 2018 compared with 2013.
  • The number of stillbirths reduced by 16% from 4.20 per 1,000 total births in 2013 to 3.51 per 1,000 total births in 2018. This is equivalent to 500 fewer stillbirths in 2018 compared with 2013. (A stillbirth is a death occurring before or during birth once a pregnancy has reached 24 weeks.)
  • Neonatal deaths reduced by 11% from 1.84 per 1,000 live births in 2013 to 1.64 deaths per 1,000 live births in 2018. This is equivalent to 170 fewer neonatal deaths in 2018 compared with 2013. (A neonatal death is the death of a baby who is born alive but dies within 4 weeks of birth.)

‘Whilst these results show a continuing downward trend in both stillbirth and neonatal death rates, there is still much work to be done to achieve the Department of Health for England’s revised target of a 50% reduction in these rates by 2025’ says Professor Elizabeth Draper, MBRRACE-UK Perinatal Lead, University of Leicester. ‘Given the slower progress towards the reduction in neonatal deaths and the high proportion of neonatal deaths of babies born premature, emphasis should be placed on reducing rates of premature birth, particularly the most extreme premature group.’

As in earlier reports ethnic origin continues to have a significant impact on mortality rates:

  • Stillbirth rates for Black and Black British babies were over twice those for White babies, whilst neonatal death rates were 45% higher.
  • For babies of Asian and Asian British ethnicity, stillbirth and neonatal death rates were both around 60% higher than for babies of White ethnicity.
  • The stillbirth rate was 1 in 295 for White babies; 1 in 188 for Asian babies and 1 in 136 for Black babies.

‘These results suggest that a more targeted approach may be required to benefit the Black and Black British and Asian populations’ says Professor Draper. ‘In the New Year we will be starting an MBRRACE-UK confidential enquiry into the deaths of babies born to Black and Black British mothers to investigate the quality of care provided for these mothers to identify whether there are any particular issues.’  

The results continue to show that women living in the most deprived areas had an 80% higher risk of stillbirth and neonatal death compared to women living in the least deprived areas. The rate of stillbirth was 1 in 383 for women living in the least deprived areas, compared with 1 in 214 for women living in the most deprived areas.

‘In order to have a major impact on these rates, public health, commissioning bodies and healthcare providers should work together to ensure maternity services can be easily accessed by all women’ says Professor Jenny Kurinczuk, MBRRACE-UK/PMRT National Programme Lead, University of Oxford.

The team in Leicester is currently working to identify sub groups of women with multiple risk factors for adverse pregnancy outcome and their geographical distribution, to facilitate the development of focused interventions.

‘MBRRACE-UK' is the collaboration  appointed by the Healthcare Quality Improvement Partnership (HQIP) to run the national Maternal, Newborn and Infant clinical Outcome Review Programme (MNI-CORP) which continues the national programme of work conducting surveillance and investigating the causes of maternal deaths, stillbirths and infant deaths.