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.
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 publication by the Centre for Epidemiology and Evidence New South Wales Mothers and Babies. The latest edition is available at http://www.health.nsw.gov.au/hsnsw/Pages/mothers-and-babies-2014.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 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
• In 2013, there were 49,066 deaths of residents in NSW. The number increased by only around 20% between 1983 and 2013. This is despite an almost 38% increase in the NSW population in that time.
• The age standardised death rate was 528.9 per 100,000 in NSW in 2013. This rate has decreased around 87% over the 30 year period from 1983 to 2013.
• In 2013, the age-adjusted male death rate was 46% higher than the female death rate. This difference has declined from almost 66% in 1983.
• In 2014, there were 318 infant deaths in NSW, which was 3.5 deaths per 1,000 live births. The infant mortality rate in Australia was 3.4 deaths per 1,000 live births in 2014.
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.
The age-adjusted death rate was 528.9 deaths per 100,000 population per year in NSW in 2013 (preliminary death data, from Australian Coordinating Registry (ACR)). There were 49,066 deaths per year in NSW in this year - 25,237 men and 23,829 women died.
The ABS reported age-standardised death rate in NSW in 2013 was 5.4 deaths per 1,000 people and 5.4 deaths per 1,000 people in the whole of Australia. The ABS reported rate was 5.4 in NSW in 2013 (ABS 3302.0), very similar to the ACR source. Some differences 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 from all causes are low in Australia and NSW by international standards. The World Health Organization 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 1,000 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 1,000 in 2008, which placed it in fifth (WHO 2010).
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.
Australian Bureau of Statistics. Deaths, Australia 2013. 3302.0. Canberra: ABS, 2014. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3302.0
Last JM (ed). A dictionary of epidemiology. Fourth edition. New York: Oxford University Press. Inc, 2001.
World Health Organization. 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 aiming to reduce deaths rates in NSW are embedded in strategies dealing with specific health issues or specific disadvantaged populations.