The loss of a baby who was either stillborn or died in the first weeks of life is a tragic event that affects around 3,000 families every year in Australia. Perinatal mortality is widely recognised as an important indicator of population health. While Australia is one of the safest places in the world to give birth, almost 1 in 100 pregnancies at or beyond 20 weeks gestation will end in a perinatal death.
Perinatal Deaths in Australia 1993–2012 represents the first comprehensive national report on perinatal mortality in Australia and includes a detailed analysis of data relating to stillbirths and neonatal deaths for the period 2011–2012 and an analysis of trends for 1993–2012. The aim of this report is to gain a better understanding of the causes of perinatal deaths at a population level and identify changes in perinatal mortality over time. Data used for this report come from information recorded in jurisdictional perinatal data collections and information collated by state and territory perinatal mortality review committees.
For the 2 years 2011 and 2012, just over 6,000 babies died during the perinatal period: a rate of 9.9 deaths per 1,000 births. Approximately three-quarters of those deaths were stillbirths (4,485) with the remaining 1,580 deaths being neonatal deaths. The rate of perinatal mortality varied by the state or territory in which babies were born, with the highest perinatal mortality rate recorded in Victoria (12.2 deaths per 1,000 births) and the lowest in New South Wales (8.3 deaths per 1,000 births).
The rates also varied considerably between different subgroups including those based on mothers’ level of remoteness, socioeconomic status, age, smoking status, body mass index (BMI) and Indigenous status. The perinatal mortality rate of babies born to mothers who identified as Aboriginal or Torres Strait Islander was almost double that of babies of non-Indigenous mothers (17.1 versus 9.6 deaths per 1,000 births). Similarly, the perinatal mortality rate was almost 50% higher among babies whose mothers smoked compared with those who did not smoke (13.3 versus 8.9 deaths per 1,000 births). The stillbirth rate for babies of teenage mothers and mothers older than 45 was more than double that for mothers aged 30–34 (13.9 and 17.1 versus 6.4 deaths per 1,000 births).
Over the 20-year period 1993–2012, the overall perinatal mortality rate was stable at around 10 deaths per 1,000 live births. There was a decrease in the rate of neonatal death (3.2 to 2.4 deaths per 1,000 live births) and an increase in the stillbirth rate (6.4 to 7.2 deaths per 1,000 births). Although remaining high, the report shows a decrease of 20% in the perinatal mortality rate among babies of Aboriginal and Torres Strait Islander mothers.
During 2011 and 2012, congenital abnormality was the leading condition in the fetus classified by the PSANZ Perinatal Death Classification as the cause of stillbirths (26.3% of stillbirths) and neonatal deaths (33.1%). An additional PSANZ Neonatal Death Classification of extreme prematurity was the leading condition contributing to deaths in the neonatal period (33.5%). When examined by Indigenous status, however, the leading cause of perinatal death among babies of Aboriginal and Torres Strait Islander mothers was spontaneous pre-term birth (26.8% of stillbirths and 48.0% of neonatal deaths).
This report provides insight into the trends in perinatal mortality in Australia, and highlights variations in some of Australia’s most vulnerable and disadvantaged population subgroups. This indicates areas that warrant further investigation and attention by clinicians, researchers and health policy makers.