NSW Perinatal Data Collection (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
1.1 Spontaneous vaginal birth: The number of selected primipara who have a spontaneous vaginal birth as a percentage of the total number of selected primipara who give birth.
1.2 Induction of labour: The number of selected primipara who undergo induction of labour as a percentage of the total number of selected primipara who give birth.
1.3 Instrumental vaginal birth: The number of selected primipara who undergo an instrumental vaginal birth as a percentage of the total number of selected primipara who give birth.
1.4 Caesarean section: The number of selected primipara undergoing caesarean section birth as a percentage of the total number of selected primipara who give birth.
Selected primipara is a woman 20-34 years of age at the time of giving birth, giving birth for the first time at greater than 20 weeks gestation; singleton pregnancy; cephalic presentation; and at 370 to 410 weeks gestation ('0' means zero days).
Data include all mothers who gave birth (stillbirth or live birth) in NSW regardless of place of permanent residence.
Types add up to more than 100% because induction of labour can precede an instrumental vaginal birth and a birth by caesarian section.
This is a national clinical indicator defined in: Australian Council on Healthcare Standards. Obstetrics Indicator Users' Manual 2014. Obstetrics version 7. Sydney: ACHS, 2014.Clinical indicators 1.1-1.4: Outcome of selected primipara.
The NSW Perinatal Data Collection (PDC), formerly the NSW Midwives Data Collection (MDC), is a population-based surveillance system covering all births in NSW public and private hospitals, as well as homebirths. The PDC is a statutory data collection under the NSW Public Health Act 2010.
The PDC encompasses all live births, and stillbirths of at least 20 weeks gestation or at least 400 grams birth weight. Prior to 2006 the PDC encompassed all births of at least 20 weeks gestation or at least 400 grams birth weight. The data collection has operated since 1987 but continuously only since 1990.
For every birth in NSW the attending midwife or medical practitioner completes a form (latest version: http://internal.health.nsw.gov.au/data/collections/mdc/NSWH%20Perinatal%20Data.pdf), or its electronic equivalent, giving demographic, medical and obstetric information on the mother and the condition of the infant. The PDC form was revised in 1998, 2006 and 2011.
There are several source systems that generate the PDC data. Completed forms are sent to the Data Integrity and Governance Unit, Information Management and Quality, in the Health System Information and Performance Reporting Branch of the NSW Ministry of Health, where they are compiled into the PDC database. Electronically submitted records were received by secure upload to the state database or encrypted via email. In 2015, almost 98% of PDC notifications were received electronically from hospital obstetric information systems.
There are several electronic systems that generate the PDC data including ObstetriX and Cerner in public hospitals and a variety of systems in private hospitals. ObstetriX is the most commonly used maternity information system in public hospitals in NSW.
Table 1. Perinatal Data Collection Notification Sources, NSW 2014
|Notification source||Local Health District or Hospital||
Per cent of PDC records 2015
|ObstetriX||All hospitals in Northern Sydney, Central Coast, South Eastern Sydney, Illawarra Shoalhaven, Hunter New England, Nepean Blue Mountains and Western Sydney Local Health Districts. Some hospitals in Mid North Coast, Northern NSW, Murrumbidgee, Southern NSW, Western NSW and Far West Local Health Districts.||58.5|
|Cerner||Sydney and South Western Sydney Local Health Districts.||18.2|
|Meditech||Ramsay Private Hospitals - North Shore Private Hospital, Westmead Private Hospital, St George Private Hospital, Kareena Private Hospital and Figtree Private Hospital.||8.3|
|Sydney Adventist Obstetric Information System||Sydney Adventist Hospital||2.0|
|Healthscope||Healthscope hospitals - Prince of Wales Private Hospital, Norwest Private Hospital, Sydney South West Private Hospital, Nepean Private Hospital and Newcastle Private Hospital||8.5|
|The Mater Hospital database||The Mater Hospital, North Sudney||2.4|
|Paper form||Remaining hospitals and homebirths||2.1|
The information sent to the NSW Ministry of Health is checked and compiled into one statewide dataset. One record is reported for each baby, even in the case of a multiple birth. The PDC includes notifications of births which occur in NSW which includes women whose usual place of residence is outside NSW and who give birth in NSW; it does not receive notifications of interstate births where the mother is resident in NSW. The collection is based on the date of birth of the baby.
Data are reported by calendar year. For this report, the PDC was accessed via SAPHaRI.
The current data collection form for the NSW Perinatal Data Collection (PDC) commenced in 2016. Codes are described in the NSW Perinatal Data Collection Manual - 2016 Edition, which is available on the internet at http://www0.health.nsw.gov.au/policies/pd/2015/pdf/PD2015_025.pdf
• Between 2011 and 2015, the number of births in NSW decreased from 97,245 to 96,391, a decline of 0.9%.
• The proportion of mothers who were teenagers continued to fall, from 3.2% in 2011 to 2.5% in 2015.
• The proportion of births to mothers over 35 years of age has remained stable since 2011.
• The proportion of mothers who smoked during pregnancy fell from 11.1% in 2011 to 8.9% in 2015.
• The proportion of babies with low birth weight remained stable over the period from 2011 to 2015 at around 6%.
• The proportion of preterm births was 7.9% of all births in 2015, an increase of around 20% in the previous twenty years.
• The perinatal mortality rate was 8.2 per 1,000 births in 2015. Over the period from 2011 to 2014 the perinatal mortality rate varied between 7.8 and 8.5 per 1,000 births.
• In 2013, there were 372 infant deaths in NSW, which was 3.7 deaths per 1,000 live births. The infant mortality rate in Australia was 3.6 deaths per 1,000 live births in 2013.
• In 2011, a change to the data collection resulted in a more specific question concerning commencement of antenatal care. This change has caused an apparent decrease in the proportion of mothers who commenced antenatal care at less than 14 weeks gestation. Among Aboriginal or Torres Strait Islander mothers, the proportion commencing antenatal care at less than 14 weeks gestation was 71.3% in 2010 compared with 61.2% in 2011. A similar effect has been observed in mothers of non-Aboriginal or Torres Strait Islander descent with 79.6% commencing antenatal care at less than 14 weeks gestation in 2010 compared with 71.7% in 2011. In 2015, 55.6% of Aboriginal mothers and 64.7% of non-Aboriginal mothers commenced antenatal care before 14 weeks gestation.
• The proportion of mothers smoking in pregnancy among Aboriginal or Torres Strait Islander mothers was 45.0% in 2015. From 2011, two questions about smoking in pregnancy are asked at data collection. These revised questions provide more opportunity for women to report their smoking history and are likely to produce a more reliable measure of smoking rates in pregnancy than the original question asked in the previous years.
• The perinatal mortality rate among babies born to Aboriginal or Torres Strait Islander mothers was 9.6 per 1,000 in 2015, higher than the rate of 8.1 per 1,000 for babies born to non-Aboriginal or Torres Strait Islander mothers.
The health of Australian mothers and babies is generally good by world standards. Maternal deaths are rare, and perinatal mortality rates are low.
The average woman in NSW can currently expect to give birth to 1.9 babies in her lifetime.
NSW mothers are getting older with the mean maternal age at first birth around 29 years and at subsequent birth just over 30. The proportion of teenage mothers is declining.
Aboriginal mothers and babies, those from socioeconomically disadvantaged areas, and some overseas-born mothers and their babies continue to experience worse outcomes than other NSW mothers and babies.
The NSW Ministry of Health maintains two population-based surveillance systems that collect information concerning pregnancy and birth: the NSW Perinatal Data Collection and the NSW Register of Congenital Conditions. They assist in monitoring the health of mothers and babies and, maternity service planning in NSW.
The implementation of the NSW Aboriginal Maternal and Infant Health Strategy has improved access to culturally appropriate maternity services for Aboriginal mothers.
The NSW Maternal and Perinatal Mortality Review Committee reviews each death of a mother or newborn baby to assess the cause and identify any possible avoidable factors. This information is used to improve services for mothers and babies.
NSW Ministry of Health at http://health.nsw.gov.au, in particular see the annual New South Wales Mothers and Babies report, published by the Centre for Epidemiology and Evidence. The latest edition is available at http://www.health.nsw.gov.au/hsnsw/Publications/mothers-and-babies-2015.pdf
Australian Bureau of Statistics at http://www.abs.gov.au, in particular see Births (ABS Cat no 3301.0)
Australian Institute of Health and Welfare at http://www.aihw.gov.au in general and in particular the AIHW's National Perinatal Statistics Unit and the annual publication: Australia’s mothers and babies.
healthdirect at http://www.healthdirect.gov.au
Population and Public Health Division. Improved reporting of Aboriginal and Torres Strait Islander peoples on population datasets in New South Wales using record linkage–a feasibility study. Sydney: NSW Ministry of Health, 2012. Available at: http://www.health.nsw.gov.au/hsnsw/Publications/atsi-data-linkage-report.pdf
Australian Council on Healthcare Standards. Obstetrics Indicator User Manual 2013. Obstetrics version 7.2. Sydney: ACHS, 2013. Available at: https://www.ranzcog.edu.au/component/docman/doc_view/267-obstetric-indicators.html?Itemid=946">