MBRRACE-UK Perinatal Mortality Surveillance Report UK Perinatal Deaths for Births from January to December 2019

Summary

MBRRACE-UK is commissioned by the Healthcare Quality Improvement Partnership (HQIP) to undertake the Maternal, Newborn and Infant Clinical Outcome Review Programme (MNI-CORP). The aims of the MNI-CORP are to collect, analyse and report national surveillance data and conduct national confidential enquiries in order to stimulate and evaluate improvements in health care for mothers and babies. This report focuses on the surveillance of perinatal deaths from 22+0 weeks gestational age (including late fetal losses, stillbirths, and neonatal deaths) of babies born between 1st January and 31st December 2019.

Content

New recommendations

1. Enhance current programmes in order to accelerate the reduction of stillbirths and neonatal deaths to meet national targets, with an emphasis on reducing rates of preterm birth, particularly the most extreme preterm group. ACTION: Policy Makers, UK Public Health Services.

2. Continue to develop innovative new programmes of research into reducing preterm birth. ACTION: Policy Makers, UK Public Health Services, Research Funders.

3. Use the MBRRACE-UK guidance for the assessment of signs of life in births before 24+0 weeks gestational age. ACTION: Trust and Health Board Directors, Clinical Directors, Heads of Midwifery, Health Professionals.

4. Ensure the continuation of targeted initiatives with health education organisations not only aimed at reducing teenage pregnancy but also providing pre-conception advice. ACTION: UK Government Education Departments, UK Public Health and Health Education Services, Primary Care Providers, Health Professionals.

5. Provide pre- and post-conception information for women aged 35 and over, clarifying the risk of stillbirth and neonatal death associated with increased maternal age to empower their decision making throughout the care pathway. ACTION: UK Health Education Services, Primary Care Providers, Trust and Health Board Directors, Clinical Directors, Heads of Midwifery, Health Professionals.

6. Initiate a research programme to inform the development of effective interventions to address health inequalities and reduce stillbirth and neonatal mortality rates. ACTION: Policy Makers, UK Public Health Services, Research Funders.

7. Develop focused initiatives to reduce stillbirths and neonatal deaths among groups of mothers at the highest risk, informed by the multidimensional effects of ethnicity, deprivation and mother’s age. ACTION: Policy Makers, UK Public Health Services.

8. Use the newly-developed MBRRACE-UK interactive maps and tables to compare stabilised and adjusted stillbirth, neonatal mortality and extended perinatal mortality rates between organisations. ACTION: Service Commissioners, Trust and Health Board Directors, Clinical Directors, Heads of Midwifery, Health Professionals.

9. Emphasise the importance of pre-conception health as a routine part of every health professional’s interaction with women who have risk factors for congenital anomaly. ACTION: UK Public Health Services, Primary Care Providers, Royal Colleges, Trust and Health Board Directors, Clinical Directors, Heads of Midwifery, Health Professionals.

10. Notify all deaths via the MBRRACE-UK system within 2 working days of the death occurring. Incorporate mechanisms for timely notification into local processes. ACTION: Trust and Health Board Directors, Clinical Directors, Heads of Midwifery, Health Professionals.