Perinatal mortality

2011
8.52010
8.22009
8.72008
8.72007
92006
8.82005
8.72004
92003
8.62002
8.72001
9.22000
9.61999
9.11998
9.31997
9.51996
8.91995
8.81994
8.9
 
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NSW Perinatal Data Collection (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.

Perinatal deaths include stillbirths and deaths within 28 days of birth (neonatal deaths). Data include deaths reported to the PDC only, deaths occurring after discharge or transfer of the baby may not be reported to the PDC. 

Data include all births in NSW regardless of mother’s place of residence.

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NSW Perinatal Data Collection

 

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.

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. In 2010, over 80% 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 2010

Notification sourceLocal Health District or Hospital

Per cent of PDC records 2010

Electronic    
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, Murrumbidgee, Southern, Western and Far West Local Health Districts 51.1 
Cerner Sydney and South Western Sydney Local Health Districts 19.4 
Meditech Ramsay Private Hospitals - North Shore, Westmead, St George, Kareena, Figtree and Tamara Private Hospitals 8.7 
Sydney Adventist Obstetric Information System Sydney Adventist Hospital 2.2 
Newcastle Private Obstetric Information System Newcastle Private Hospital 2.0
 Total   83.4
 Paper form Remaining hospitals and homebirths 16.6
 Total   100 

 

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. 

 


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Codes: NSW Perinatal Data Collection

The current data collection form for the NSW Perinatal Data Collection (PDC) commenced in 2011. Codes are described in the NSW Perinatal Data Collection Manual - 2011 Edition, which is available on the internet at http://www0.health.nsw.gov.au/resources/publichealth/mph/pdc_manual_2011.asp


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Infant mortality

Number and rate in NSW and in Australia by year. Rate by Aboriginality in NSW. Number and rate by Local Health District and year (preliminary death data).
 
Key points: Pregnancy and the newborn period

Recent trends

• Between 2007 and 2012, the numbers of births in NSW increased from 96,030 to 99,510, a rise of 3.6%. 

• The percentage of mothers who were teenagers continues to fall, from 3.5% in 2007 to 3.2% in 2012.

• The proportion of births to mothers over 35 years of age increased from 22.8% of all mothers in 2007 to 23.7% in 2012. 

• The rate of smoking during pregnancy fell from 12.8% in 2007 to 10.4% in 2012. 

• Rates of low birth weight remained stable over the period from 2007 to 2012 at around 6%.

• The perinatal mortality rate was 8.2 per 1,000 births in 2012. Over the period from 2007 to 2012 the perinatal mortality rate varied between 8.2 and 9.0 per 1000 births.

Aboriginal and Torres Strait Islander mothers and babies

• 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 2012, 51.0% of Aboriginal mothers and 61.6% of non-Aboriginal mothers commenced antenatal care before 14 weeks gestation.

• The rate of smoking in pregnancy among Aboriginal or Torres Strait Islander mothers was 49.9% in 2012. 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 12.1 per 1,000 in 2012, higher than the rate of 8.0 per 1,000 for babies born to non-Aboriginal or Torres Strait Islander mothers. 
  

 


Introduction: Pregnancy and the newborn period

Demography

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.

Burden of disease and social and economic disadvantage

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.

More than 90% of NSW mothers commence antenatal care in the first half of pregnancy, however there are differences between regions of NSW, Aboriginality and country-of-birth.


Interventions: Pregnancy and the newborn period

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 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.


For more information: Pregnancy and the newborn period

Useful websites include:

NSW Ministry of Health at http://health.nsw.gov.au , in particular see annual publication by Centre for Epidemiology and Research New South Wales Mothers and Babies. The latest hard copy edition is available at http://www.health.nsw.gov.au/hsnsw/Pages/mothers-and-babies-2010.aspx

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 AIHW ‘s National Perinatal Statistics Unit and the annual publication: Australia’s mothers and babies.

HealthInsite at http://www.healthinsite.gov.au

Population and Public Health Division. Improved reportingof Aboriginal and Torres Strait Islander peoples on population datasets in New South Wales using recordlinkage–a feasibility study. Sydney: NSW Ministry of Health, 2012. Available at http://www0.health.nsw.gov.au/pubs/2012/pdf/imprvd_report_pop.pdf

Australian Council on Healthcare Standards. Obstetrics Indicator Users' Manual 2012. Obstetrics version 7. Sydney: ACHS, 2012. Available at http://www.achs.org.au/media/44783/obstetricsversion7.pdf


Key points: Deaths

    • In 2011,there were 50,891 deaths of residents in NSW. The number increased by only around 25% between 1981 (40,551 deaths) and 2011. This is despite an almost 38% increase in the NSW population in that time.
     

• The age standardised death rate was 578.6 per 100,000 in NSW in 2011. The rate decreased by almost 44% over the 30 year period from 1981 to 2011 (48.5% in males and 40% in females).

• In 2011, the age-adjusted male death rate was 45% higher than the female death rate. This difference has declined from almost 70% in 1981.

    • In 2012, there were 312 infant deaths in NSW, which was 3.2 deaths per 1,000 live births. The infant mortality rate in Australia was 3.3 deaths per 1,000 live births in 2012.

Introduction: Deaths

Definition

Death or mortality statistics are published at regular intervals in most countries and usually show numbers and rates of deaths by sex, age and other variables. A death rate is an estimate of the proportion of the population that dies during a specified period (Last 2001). In this report it is expressed as the number of deaths per 100,000 population (person-years).

The proportion of older people varies between geographic areas and over time and can therefore influence death rate comparisons within these dimensions. Age-adjustment (also known as age-standardisation) allows for the comparison of death rates across geographic areas and over time after removing the effects of the different age structures in these dimensions.

Refer to the Methods tab for more information.

Death rates in NSW and in Australia

The age-adjusted death rate was 578.6 deaths per 100,000 population per year in NSW in 2011 (preliminary death data, from Australian Coordinating Registry (ACR)). There were 50,891 deaths per year in NSW in this year - 25,887 men and 25,004 women died.

The ABS reported age-standardised death rate in NSW in 2012 was 5.4 deaths per 1,000 people and 5.5 death per 1,000 people in the whole of Australia.  The ABS reported rate was 5.8 in NSW in 2011 (ABS 3302.0 2013), very similar to the ACR source. Some diffferences between the ABS figures and those in this report include the fact that the ABS reports deaths by the year of registration and this report uses the year of occurrence as the basis of reporting, which mainly affects numbers in the latest reporting year. Refer to the Methods tab for more information.

Death rates internationally

Death rates from all causes are low in Australia and NSW by international standards.  The WHO classifies Australia into an ‘A stratum’, with very low child and adult mortality (WHO 2003). Comparisons by country reveal that the probability of dying between 15 and 60 years per 1000 population (WHO calculated adult mortality rate) spans from low 50s in selected developed countries to 600-700 in some African counties. Australia’s rate was 61 per 1000 in 2008 which placed it at the fifth place (WHO 2010).

Causes of death in NSW by sex and age in 2010 and 2011

The leading causes of all deaths in NSW (after averaging results from the last two years) were cardiovascular diseases followed by malignant neoplasms (or cancers), each contributing around one third of all deaths. Respiratory diseases and injury and poisonings were distant third and fourth causes of all death, each accounting for less than 10% of deaths.

Analysis by sex and age reveals striking differences between males and females and different ages. One of the main differences is that injury and poisoning is of much greater importance as a cause of death in younger ages in both sexes, but especially in males. It constitutes over 70% of all deaths in males aged 15-24 years and over 50% in females of the same age.

References

Australian Bureau of Statistics. Deaths, Australia 2012. 3302.0. Canberra: ABS, 2013. Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/3302.0

Last JM (eds). A dictionary of epidemiology. Fourth edition. New York: Oxford University Press. Inc, 2001.

World Health Organisation. World health statistics 2010. Geneva: WHO, 2010. Available at http://www.who.int/whosis/whostat/en/index.html

World Health Organization. The world health report 2003 - shaping the future. Geneva: WHO, 2003. Available at http://www.who.int/whr/2003/en/


Interventions: Deaths

Interventions aiming to reduce deaths rates in NSW are embedded in strategies dealing with specific health issues or specific disadvantaged populations.


For more information: Deaths

Useful websites include:

Australian Bureau of Statistics at http://www.abs.gov.au

Australian Institute of Health and Welfare at http://www.aihw.gov.au

HealthInsite at http://www.healthinsite.gov.au