MBRRACE has published the second perinatal mortality report.

The report found a marginal decrease in the number of stillbirths in England and Wales in 2014 (3,252 compared with 3,286 in 2013) relative to a marginally increased birth rate (782,311 births compared with 781,932), giving a stillbirth rate of 4.16 per 1,000 births, significantly higher than other developed countries.

There was a significant variety in outcomes by region, socioeconomic status and ethnicity. In particular:

  • Stabilised & adjusted periantal mortality rates varied significantly across regions and trusts (from 4.9 to 7.1 deaths per 1,000 total births)
  • Perinatal mortality is over 50% more likely in areas with the highest levels of social deprivation in the UK
  • Perinatal mortality is over 80% higher for babies of Black or Black British and Asian or Asian British ethnicity

The key recommendations included:

  • Organisations with above average mortality rates should conduct a review to establish why (given that the rates are adjusted to be comparable with equivalent organisations). And ALL organisations, irrespective of their extended perinatal mortality rate, should investigate individual stillbirths in accordance with standards.
  • The NHS and professional bodies should establish targets against which to assess services.
  • Trusts should improve the accuracy and completeness of the data provided when reporting stillbirths, particularly maternal data.
  • Trusts should improve their coding of the cause of death, based on the Cause Of Death & Associated Conditions (CODAC) classification, to allow targeted interventions to reduce stillbirth. 46% of stillbirths were classified as “unknown cause”, which provides no useful information.
  • Post mortem should always be offerered for stillbirths and the placenta should always be submitted for histological examination, preferably by a specialist pathologist.

Direct links to documents via MBRRACE

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