Causes of perinatal death

Causes of perinatal deaths were classified according to the Perinatal Society of Australia and New Zealand (PSANZ) Perinatal Mortality Classification System, version 2.2, as part of each state or territory’s perinatal mortality review process.

The PSANZ Perinatal Mortality Classification System incorporates a Perinatal Death Classification (PSANZ-PDC) and an additional Neonatal Death Classification (PSANZ-NDC).

The PSANZ-PDC system classifies all perinatal deaths (stillbirths and neonatal deaths) by the single most important factor which led to the chain of events which resulted in the death (refer to Technical notes—Definitions used in reporting for cause of death classifications).

In 2015 and 2016:

The most commonly classified causes for all perinatal deaths were:

  • Congenital anomaly (29.8%)
  • Unexplained antepartum death (14.7%)
  • Spontaneous preterm birth (11.7%).

The most commonly classified causes of stillbirths were:

  • Congenital anomaly (29.4%)
  • Unexplained antepartum death (19.6%)
  • Specific perinatal condition (9.3%).

The most commonly classified causes of neonatal deaths were:

  • Congenital anomaly (31.2%)
  • Spontaneous preterm (28.8%)
  • Perinatal infection (10.6%).
  • Maternal conditions were a more prominent classified cause of death at gestations below 26 weeks and unexplained antepartum death was a less prominent cause.
  • Perinatal deaths due to congenital anomaly were the commonly classified cause of death for singleton babies, while specific perinatal conditions, such as cord entanglement, were the most commonly classified cause of death for multiples.
  • Perinatal deaths due to congenital anomaly were the main cause regardless of their birthweight for gestational age.
  • The most commonly classified causes of antepartum stillbirths were congenital anomaly and unexplained antepartum death.
  • Congenital anomaly and spontaneous preterm birth were the most commonly classified causes among intrapartum stillbirths and neonatal deaths.
  • Neonatal deaths due to spontaneous preterm were the main classified cause for babies considered an appropriate birthweight for their gestational age (32.8%).

Additional causes of neonatal deaths

The PSANZ-NDC is an additional classification system applied only to neonatal deaths to identify the single most important factor in the neonatal period which caused the death—the time from birth to 28 days.

In 2015 and 2016, the most important factors in neonatal deaths were:

  • Extreme prematurity (36.9%)
  • Congenital anomaly (29.7%)
  • Neurological conditions (13.1%).