Report shows rate of stillbirths and neonatal deaths decreased in 2023 but persistent inequalities remain

The MBRRACE-UK collaboration, jointly led by Oxford Population Health’s National Perinatal Epidemiology Unit and the University of Leicester’s TIMMS research group, has today published a ‘State of the Nation’ report on perinatal deaths of babies born in the UK in 2023. 

The State of the Nation report is a concise overview of perinatal deaths in the UK focusing on five key areas: perinatal mortality rates in the UK; mortality rates for trusts and health boards; mortality rates by gestational age (weeks of pregnancy completed before birth); mortality rates by ethnicity and socio-economic deprivation; and a description of the causes of perinatal deaths in the UK.  

This report focuses on births from 24 completed weeks of pregnancy, but includes babies born at 22 and 23 completed weeks of pregnancy where rates are presented by gestational age. The figures presented in this report do not include terminations of pregnancy. 

Key findings: 

• Extended perinatal mortality rates continued to decrease in 2023, driven by a reduction in stillbirth rates. The extended perinatal mortality rate decreased to 4.84 deaths per 1,000 total births

• The stillbirth rate decreased from 3.35 per 1,000 total births in 2022 to 3.22 per 1,000 total births in 2023. The neonatal mortality rate decreased from 1.69 per 1,000 live births in 2022 to 1.63 per 1,000 live births in 2023

• Wide variation in neonatal mortality rates remained in 2023, with 42% of trusts and health boards having rates that fall within 5% of the average for organisations that provide similar types of care 

• Late fetal loss, stillbirth and neonatal mortality rates decreased in almost all gestational age groups between 2022 and 2023, with the largest reduction seen in babies born at full term (between 37 and 41 weeks’ gestation). However, neonatal mortality increased for babies born between 24 and 31 completed weeks’ gestational age. Babies born at 22 and 23 weeks accounted for an increasing proportion (25%) of all neonatal deaths. Preterm births remained a significant factor with 76% of stillbirths and 75% of neonatal deaths occurring in babies born before 37 weeks

• Inequalities by levels of deprivation continue. Stillbirth rates for babies born to mothers living in the most deprived areas remain significantly higher than those born to mothers living in least deprived areas. Neonatal mortality rates for babies born to mothers from the most deprived areas increased for the second year, and are now more than twice that of babies born to mothers from the least deprived areas (2.50 per 1,000 live births compared with 1.03 per 1,000 live births)

• Significant ethnic disparities in perinatal outcomes persisted. Stillbirths declined for Black and White babies but increased by 10% for Asian babies. Babies of Black ethnicity remain more than twice as likely to be stillborn than babies of White ethnicity. Neonatal mortality rates decreased for babies of all ethnicities but remained highest for Asian and Black babies

• The most common causes of stillbirth were placental issues, congenital anomalies, umbilical cord complications, and fetal conditions but the cause remains unknown for one-third of stillborn babies. For neonatal deaths, the most common cause was congenital anomalies, which contributed to one-third of all neonatal deaths.  

Dr Ian Gallimore, Project Manager for MBRRACE-UK, said: "These findings highlight continued progress in reducing perinatal mortality but underscore the need for targeted interventions to address disparities by socioeconomic status, ethnicity, and gestational age. Recent MBRRACE-UK reports have made national level recommendations in support of these aims, but focused work at local provider, network and commissioner level may be required to understand and tackle these issues in an effective manner."

The next MBRRACE-UK Saving Lives, Improving Mothers’ Care confidential enquiry report into maternal deaths in the UK will be published later in 2025. The details of the cases presented in the confidential enquiry reports are strictly confidential but the reports will include brief anonymised summaries of the care received by some parents and their babies as illustrative examples.