Latest report on stillbirth and neonatal death rates for local populations and individual NHS Trusts and Health Boards across the UK in 2016
Research published today shows that the stillbirth rate associated with twin pregnancy in the UK has reduced by around 44% over the period 2014 to 2016.
Rates of neonatal mortality associated with twin pregnancy have similarly reduced by a third. Over this period the increased risk of stillbirth and neonatal death in twin pregnancies compared to singleton pregnancies has also reduced by just less than a third.
Although the stillbirth and neonatal deaths rates overall are reducing over time the reduction in these rates between 2013 and 2016 is only around 6.5%. Targeted initiatives are required to reduce rates more rapidly if the current Government ambition is to halve the rates of stillbirth and neonatal death in England by 2025.
The MBRRACE-UK* report focuses on rates of stillbirth and neonatal death across the UK for babies born at 24 weeks of gestation or more. The report found that in 2016 the stillbirth rate was 3.93 per 1,000 total births, a fall from 4.20 per 1,000 total births in 2013. Following analysis to account for some of the important factors that influence the rate of death such as poverty, mother’s age, multiple birth and ethnicity variation in stillbirth rates across the various populations of the UK has reduced with all rates falling to within 10% of the UK average. This suggests an equitable standard of service provision across the UK. However UK stillbirth rates still remain high compared with many similar European countries and increased efforts should be made to try and reduce stillbirth rates in line with the best of these countries.
Over the same four year period the rate of reduction in the neonatal death rate is similar to stillbirths at 6.5%: from 1.84 to 1.72 deaths per 1,000 live births indicating that more work is required to prevent these deaths in the future and to achieve national ambitions. As in previous years broadly similar NHS Trusts and Health Boards have been grouped together by their type of care or size in order to provide an appropriate comparison of their mortality rates. A traffic light system has been used to highlight those where action is needed to improve outcomes. Much of the variation seen in neonatal mortality rates is accounted for by differences in the proportion of babies dying from a major congenital anomaly.
Professor Elizabeth Draper, Perinatal lead for the MBRRACE-UK programme at Leicester, said: “It’s great to see that there has been a significant reduction in the stillbirth and neonatal mortality rates associated with twin pregnancies. This needs further investigation to see if there are lessons to be learnt for all pregnant women that will help us reduce overall stillbirth and neonatal death rates and move us closer to the lowest rates seen for the best of our European partners”.
Dr Brad Manktelow, Associate Professor at Leicester, who led the statistical analysis, said: “Variation in the rates of perinatal mortality across the UK persist, even after taking into account the effects of chance and the case-mix differences we are able to account for. Those Trusts and Health Boards with a high mortality rate should carry out an initial investigation of their data quality and possible contributing local factors.”