Lowest number of stillbirths in a decade in 2018

The stillbirth rate in 2018 was 3.54 per 1,000 births; and the early neonatal death rate was 1.77 per 1,000 live births. A further 30 late neonatal deaths were reported in 2018. Picture: iStock

The number of stillbirths or early neonatal deaths in Ireland during 2018 was the lowest in almost a decade, although 2019 saw a slight increase.

That is according to the latest perinatal mortality audit with data from all 19 maternity units.

This is the eighth audit by the Perinatal Mortality Group, based in the National Perinatal Epidemiology Centre (NPEC) at University College Cork.

The audit found: “There were an additional 25 stillbirths and 10 early neonatal deaths in 2019” compared to the year before.

However, the audit states this is not an unusual fluctuation over two years, finding 2018 had “the lowest national perinatal mortality rates” they have recorded.

Director of the NPEC Professor Richard A Greene said: “This report also shows, for the first time, the maternity service commitment to transparency with the identification of individual units in the report.” 

Prof Green called for a discussion around how perinatal deaths are recorded in Ireland, saying: “We should consider assessing a similar cohort of babies in a similar way to other developed countries.” 

It is difficult to compare Ireland’s stillbirth rate internationally as the definition is different to that more widely accepted, the audit states.

Clinical recommendations

The audit makes a number of clinical recommendations, including to support improving the detection of foetal growth restrictions which could lead to earlier deliveries.

In 2018, there were 325 stillbirths or early neonatal deaths. The perinatal mortality rate (PMR) was 5.3 deaths per 1,000 births.

The audit states when this is “corrected for congenital anomaly” the rate was 3.2 per 1,000 births.

The stillbirth rate in 2018 was 3.54 per 1,000 births; and the early neonatal death rate was 1.77 per 1,000 live births. A further 30 late neonatal deaths were reported in 2018.

Then in 2019 there were 360 stillbirth or early neo-natal deaths reported. This gave a PMR of 6.04 deaths per 1,000 births.

The audit found a higher variation in rates across the hospitals in 2019 than in 2018, and that larger hospitals tended to have a higher mortality rate due to accepting more high-risk pregnancies. Picture: iStock

When this was corrected for congenital anomaly, the rate was 3.73 per 1,000 births. The stillbirth rate was 4.06 per 1,000 births; and the early neonatal death rate was 1.99 per 1,000 live births.

A further 32 late neonatal deaths were reported to the audit team in 2019.

The audit found a higher variation in rates across the hospitals in 2019 than in 2018, and that larger hospitals tended to have a higher mortality rate due to accepting more high-risk pregnancies.

None of the units were marked as having an unusually high infant mortality rate during 2018 or 2019.

The audit shows Limerick University Maternity Hospital had a perinatal mortality rate under the national rate both years. Cork University Maternity Hospital was under the national rate in 2018 and slightly over in 2019.

The rate at University Hospital Kerry in 2018 was half the national rate, and in 2019 was significantly lower again.

The rate at University Hospital Waterford was under the national rate in 2019, and slightly over in 2018.

The audit showing mortality rates for all maternity units can be seen here.