Perinatal And Neonatal Mortality And Coping With Perinatal Loss

Front 1

What are the UK definitions of perinatal and infant death?

Back 1

 Miscarriage – pregnancy loss < 24 weeks
 Stillbirth – baby born >24/40 showing no signs of life
 Neonatal death – baby born alive but dies in the first 28 days of life
 Early neonatal death – death 0-7 completed days
 Late neonatal death – death 7-28 days
 Infant death – all deaths in the first year of life
 Postneonatal infant death – deaths 28 days-1 year

Front 2

What are the rates associated with perinatal and infant death?

Back 2

 Stillbirth rates – number of stillbirths for each 1000 total births (live and stillbirths)
 Perinatal mortality rate – number of stillbirths and early neonatal deaths per 1000 total births
 Neonatal mortality rate – number of neonatal deaths (early and late) for each 1000 live births
 Infant mortality rate – number of infant deaths for each 1000 live births

Front 3

What are the modifiable factors that contribute to death?

Back 3

Front 4

What factors explain these international differences in perinatal mortality?

Back 4

 Maternal health
 Nutrition
 Access to services
 Income
 Family size
 Birthweight
 Prematurity

Front 5

What major diseases contribute to perinatal mortality in the UK?

Back 5

 Prematurity (Surfactant deficiency, periventricular haemorrhage, necrotising enterocolitis, infection)
 Congenital abnormalities (congenital heart disease, chromosomal, neural tube, diaphragmatic hernia)
 Asphyxia (before and during labour)
 Infections (congenital, intrapartum and acquired)
 ‘Unexplained’ stillbirth – probably a major
contribution from impaired placental function
 Sudden infant death (mostly post-neonatal deaths)

Front 6

What are the relative proportions of the above causes of death in newborns?

Back 6

Immaturity related conditions 58.5%
Congenital anomalies 26.1%
Asphyxia, anoxia or trauma (intrapartum) 10.2%
Antepartum infections 1.9%
Infections 0.9%

Front 7

What are the causes of stillbirths and their relative proportions?

Back 7

Remaining antepartum deaths (unexplained) 51.4%
Asphyxia, anoxia or trauma (antepartum) 22.5%
Congenital anomalies 14.5%
Other specific conditions 5.8%
Other conditions 2.5%
Asphyxia, anoxia or trauma (intrapartum) 2.3%
Antepartum infections 0.8%

Front 8

What are the proportions of causes of neonatal mortality?

Back 8

Immaturity related conditions 55%
Congenital anomalies 28.8%
Asphyxia, anoxia or trauma (intrapartum) 9.1%
Antepartum infections 2.3%
Infections 1.3%
Sudden infant deaths 0.8%

Front 9

What are the causes of postneonatal infant mortality?

Back 9

Congenital anomalies 28.9%
Other conditions 21.9%
Immaturity related conditions 15.0%
Sudden infant deaths 13.7%
Infections 11.9%
External conditions 3.1%
Other specific conditions 3.0%
Asphyxia, anoxia or trauma (intrapartum) 2.0%
Antepartum infections 0.3%

Front 10

Which birthweights are associated with the highest mortality rates?

Back 10

<1500g in all stillbirths, perinatal, neonatal, postneonatal

Front 11

Which ethnicity has the highest risk of perinatal mortality?

Back 11

Bangladesh, Pakistani, African

Front 12

What measures contribute to perinatal mortality?

Back 12

 Specific diseases & conditions
 Birthweight & Gestation
 Uteroplacental dysfunction
 Country of birth
 Mother’s country of birth
 Social class
 Maternal age & parity
 Access to healthcar