New report in Baby Loss Awareness Week shows stark inequalities in rates of neonatal mortality – Bliss says urgent action must be taken

Posted on October 14, 2021

Bliss responds to the latest MBRRACE-UK Perinatal Mortality Surveillance Report.

Bliss is calling for renewed action to tackle high rates of neonatal mortality as new figures released in Baby Loss Awareness Week show Asian and Black babies and women living in the most deprived areas of the country are at substantially increased risk of neonatal mortality.

The latest MBRRACE-UK Perinatal Mortality Surveillance Report examining perinatal deaths from 2019 has found that, while the overall rate of neonatal mortality has fallen by 12% since 2015, there is still significant work to do to reduce this rate to match the best in the world, including to meet the Government’s National Ambition of achieving a 50% reduction in neonatal death in England by 2025.

Key to achieving this target is to ensure that the widespread and unwarranted variation in neonatal mortality is addressed as a matter of urgency.

Findings from the report show:

  • Women living in the most deprived areas had a 73% higher risk of neonatal death compared to women living in the least deprived areas, and that this excess risk had increased between 2015 and 2019.
  • Asian and Asian British babies had a 60% increased risk of neonatal mortality compared to white babies.
  • Black and Black British Babies had a 43% increased risk of neonatal mortality compared to white babies.
  • Just under half of all neonatal deaths in 2019 were of babies born extremely premature (before 28 weeks of pregnancy)
  • There is wide variation in the rates of neonatal mortality among Trusts, Health Boards and NICUs, with only 15% of Trusts and Health Boards with a Level 3 Neonatal Intensive Care Unit (NICU) and neonatal surgical provision having a neonatal mortality rate within 5% of their comparator group – even when rates had been stabilised, adjusted and deaths due to congenital mortality excluded.

Caroline Lee-Davey, Chief Executive of Bliss, said: “It is deeply shocking that today’s report shows a continued higher risk of neonatal mortality among babies born in the most deprived areas, as well as among babies from certain ethnic minority groups – and even more so that the difference in the risk of death between those living in the most deprived areas and those in the least has actually increased between 2015 and 2019. It is shameful that in the UK babies are more likely to die depending on their ethnicity or where their parents live, and it is vital that these ongoing health inequalities are addressed as a matter of urgency.

“While it is positive to see further reductions in the overall neonatal mortality rate, today’s report highlights how much more needs to be done if the National Ambition of halving neonatal deaths in England is to be achieved by 2025. Further research must be undertaken to develop interventions which work to reduce the neonatal death rate equitably – and this must include working closely with families. Behind every statistic in this report is a baby who has died and a family who has endured this unimaginable loss, and our hearts go out to them”.

Yesterday also marked the third publication of findings from the National Perinatal Mortality Review Tool which supports services across the UK to better understand how babies die, to provide answers to families and to share learning to reduce incidences of perinatal death over time.

Learning from reviews is vital to understand how to reduce variation and the rate of neonatal mortality, and it is positive to note that clear progress has been made to ensure that reviews relating to babies who died in the neonatal period included a neonatologist, rising from less than 25% to over 80%.

However, the latest report has found that, of the 1,381 neonatal deaths reviewed using the PMRT between March 2020 and February 2021, 16% were potentially preventable. This is an increase on the proportion of neonatal deaths deemed to be potentially preventable in previous years, which was 9% in 2018/19, and 12% in 2019/20.

Caroline Lee-Davey added: “Each of the 1,381 neonatal deaths reviewed will have devastated a family, and it is hugely distressing that the proportion where different care may have resulted in a different outcome has increased compared to the past two years. This provides further urgency to the need for every hospital to take action to ensure learning is taken forward and drives genuine improvements in care.”