Scotland perinatal-early infant mortality rate improvement on UK average

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by a Newsnet reporter

A report recently published by the United Nation’s World Health Organisation (April 2011) which studied the incidence of stillbirths in various nations places the UK in joint 33rd position, well down the league table of 193 nations and shows Scotland doing particularly poorly compared to other European nations.

In the incidence of stillbirth the UK ranks in the same category as nations like Albania, Mexico, Costa Rica and Kazakhstan which are not generally noted for their first class public health services.  With an average stillbirth rate of 3.5 per 1000 births, the UK has figures which are amongst the highest in the developed world.  In Scotland the situation is even worse.  The Scottish figure of 4.9 per 1000 means Scotland ranks behind countries such as Latvia, Romania and Thailand.

The average UK stillborn rate is however quite variable and regional variations can be quite marked.  Usually these variations are linked to poverty.  The UK average masks big postcode differences, a woman in the Midlands has a 33% greater risk of having a stillborn child than she would if she lived in the South-West of England.

In Scotland, perinatal stillbirths fell from 5.3 per 1,000 births to 4.9 per 1000 births but still remain above the UK average (a stillborn child being defined as born after the 24th week onwards – Stillbirth Definition Act, 1992).  

In the first move of its kind since devolution, the Scottish government set up the Scottish Stillbirth Working Group in February to investigate ways of improving Scottish stillbirth statistics which is due to report back soon.  The aim is to lower the stillbirth rate and Scottish hospitals are collecting detailed data to help identify the underlying causes of stillbirth and improve the situation.

A spokeswoman for SANDS (Stillbirth And Neonatal Death charity) praised the Scottish Government for “having taken the lead in tackling the painful issue”, adding, “Scottish stillbirth rates are higher than the rest of the UK and as yet it is unclear exactly why this is.”

Understood causes – often outwith the control of the NHS in Scotland include:

  • Around half of all pregnant women consume alcohol during pregnancy, which raises the risk of stillbirth by 40%.
  • Young women smoking during pregnancy.  Smoking during pregnancy raises the risk by 40%, although the authors suggest that this is likely to be a conservative estimate.  Some other studies suggest the risk could be double.
  • A woman who is over 35 years of age.  Increasingly women are putting off having children until later in life.
  • Obesity levels, high blood pressure, diabetes and giving birth for the first time increases stillbirth risk.

However the statistics do contain some positive news for Scotland.  The combined death rate of newly born infants in Scotland (over 24 weeks gestation but who die before they are 7 days old) was 7.4 per 1000 total births which gives Scotland a slightly lower overall mortality rate compared to England and Wales where there were 7.6 deaths per 1,000 total births in 2009, according to The Office for National Statistics.

Office for National Statistics (England and Wales) 2009: http://www.statistics.gov.uk/pdfdir/ipm0311.pdf

Scottish Perinatal and Infant Mortality and Morbidity report, 2009: http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publications/2011-01-25/mat_spimmr_2009.pdf?62525576354