Despite overall falls in UK rates of stillbirth and neonatal deaths over the past 20 years, deaths caused by infections and prematurity in multiple births have remained unchanged, reveals research in the Fetal and Neonatal Edition of the Archives of Disease in Childhood.
The authors assessed almost 687,000 births to mothers resident in the North of England between 1982 and 2000. These were recorded as part of the Northern Region Perinatal Mortality Survey.
Between 1982 and 2000, 3500 babies were stillborn, equivalent to 51 per 10,000 births, and 3315 babies died within the first 28 days of life, equivalent to 48.5 per 10,000 births. Mothers over the age of 35 and under 20 were more likely to experience a stillbirth or the death of their newborn.
Most of the stillbirths were caused by lack of oxygen (hypoxia) before labour started, but in around one in 10 cases, this happened during labour. Deaths caused by lack of oxygen during labour halved between 1982-2000.
Almost four out of 10 (39%) of the babies dying soon after birth did so because they were born premature. Congenital abnormalities accounted for just under a third (28%) and hypoxia during labour for a further one in eight (13%).
Around 2% of the total births during the study period were multiple births. In this group, the rate of stillbirths was almost four times as high as that for singleton births. The risk of death as a result of prematurity was also much higher.
Death rates among multiple birth newborns as a result of prematurity or congenital abnormalities did not fall substantially, and the proportion of low or very low birthweight babies increased.
The authors point out that although there have been dramatic improvements in survivals for very premature babies in recent years, the risk of death for a newborn is still strongly linked with low birth weight.
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