Babies of Indigenous and rural mothers at greater risk
While Australia is one of the safest places in the world to give birth, close to 1% of babies are stillborn or die in the first month of life, according to a report released today by the Australian Institute of Health and Welfare (AIHW). While the stillbirth rate is remaining steady over time, the newborn rate (neonatal death rate) has fallen.
The report, Perinatal deaths in Australia 2013–2014, shows that in the period 2013–2014 there were about 620,000 babies born in Australia with approximately 6,000 (9.7 per 1,000 births) dying during the perinatal period.
Perinatal deaths refer to stillbirths and neonatal deaths. Stillbirths are classified as deaths among babies born at 20 or more weeks of gestation or of 400 grams or more birthweight, while neonatal deaths occur from birth to 28 days old. Deaths among babies born before this time, or at lower birthweights, are classified as miscarriages.
The report shows that there were about 4,400 stillbirths and 1,600 neonatal deaths in the period 2013–2014. This is a rate of about 7 and 3 deaths per 1,000 births respectively.
‘Between 1995 and 2014 there has been an overall reduction in perinatal deaths, down from 10.2 to 9.7 per 1,000 births,’ said AIHW spokesperson Dr Fadwa Al-Yaman.
‘There has also been a reduction in the neonatal death rate, falling from 3.2 to 2.6 per 1,000 births, but the stillbirth rate has remained relatively unchanged, varying between 6.7 and 7.5 deaths per 1,000 births’.
The report shows that the most common causes of perinatal death were congenital anomaly (for example, congenital heart disease or neural tube defect), death of the baby during pregnancy for unknown reasons, and spontaneous preterm birth (the onset of labour prior to 37 weeks gestation).
Despite overall improvements, some factors influence the likelihood of perinatal deaths. For example, it is much more common among babies born to Indigenous mothers compared to non-Indigenous mothers, but this too has seen some improvement.
‘The perinatal death rate among babies born to Indigenous mothers has improved over time, from 19 deaths per 1,000 births in 2005–2006 to about 16 in 2013–2014,’ Dr Al-Yaman said.
Similarly, babies born to mothers living in remote and very remote areas were 65% more likely to die during the perinatal period than babies born to mothers living in major cities or inner regional areas.
‘The perinatal death rate was 15.2 deaths per 1,000 births among babies born to women who lived in remote and very remote areas, compared to 9.2 deaths in major cities and inner regional areas,’ Dr Al-Yaman said.
Dr Al-Yaman said that the report showed some positive trends in the overall reduction of perinatal deaths, but that it was important to continue monitoring this important issue and building the evidence base to drive better outcomes for mothers and babies.
‘The report provides valuable information on the trends of perinatal deaths to inform maternity and newborn services, policy and practice,’ she said.
Last month, an AIHW report revealed variations in the health of mothers and babies based on their location, including higher rates of mothers smoking during pregnancy and babies of a low birthweight in remote areas, both of which are risk factors for perinatal death.