Charity warning over ‘almost stagnant’ neonatal death rates

Latest figures from the Office for National Statistics show the neonatal mortality rate in England in 2018 was 2.8 deaths per 1,000 live births down from 2.9 in 2017.

“Today’s figures show the neonatal death rate has remained almost stagnant”

Justin Irwin

However, the 2018 rate was higher than an all-time low of 2.7 per 1,000 seen in 2013, 2014 and 2015, according to the ONS report – called Deaths registered in England and Wales: 2018.

In contrast, other key findings from the new report included the fact the stillbirth rate in England hit an all-time low of 4 per 1,000 births in 2018 – down from 4.1 in 2017.

To achieve a government ambition to halve stillbirth and neonatal deaths in England between 2010 and 2025, this would mean reducing the stillbirth rate to 2.6 per 1,000 births and neonatal mortality to 1.5 deaths per 1,000 live births, said the report.

The 2018 stillbirth rate in Wales was 4.4 per 1,000 births and the neonatal mortality rate was 2.5 deaths per 1,000 live births.

The ONS said the trend in neonatal mortality since 2010 should be considered in the “context” of the increasing number of extremely pre-term births – below 23 weeks gestation – being recorded as live births in recent years.

”The trend in neonatal mortality should be considered in the context of the increasing number of extremely pre-term births”

ONS report

For example, it highlighted that there were 376 recorded in England and Wales in 2014, but this had risen to 564 by 2017.

“Unfortunately, many of these babies do not survive, thereby impacting the neonatal (and infant) mortality rates,” it said in its report.

It added: “The reason for the increase needs further investigation but there are several potential reasons including changes in obstetric and neonatal practice.”

But, in its response to the ONS report, the premature and sick baby charity Bliss said the new figures should represent a “wake-up call for government”.

Justin Irwin, chief executive of Bliss, said: “Today’s figures show the neonatal death rate has remained almost stagnant.

“The national ambition to halve neonatal death in England by 2025 will not be achieved unless swift action is taken to reduce this figure at a greater pace,” said Mr Irwin.

He called on the government and NHS to “redouble their efforts” to introduce the improvements to neonatal care, as outlined in the NHS Long term Plan for England.

He added: “We urge the government to ensure sufficient resources are made available to fully implement the recommendations of the Neonatal Critical Care Review, in order to ensure that every baby born premature or sick is cared for in the right level of neonatal unit which is suited to their needs, with the right numbers of expert staff – so that every baby has the best chance of survival.”

The ONS report also included overarching figures on deaths registered in England and Wales during 2018, which highlighted dementia and Alzheimer’s disease as major causes.

It showed that dementia and Alzheimer’s disease remained the leading cause of death in England and Wales in 2018, claiming the lives of nearly 69,500 people.

In all, there were 541,589 deaths registered last year. While 2018 saw the highest number of deaths from all causes since 1999, the ONS said death rates had remained more or less stable since 2011 when the age and size of population was taken into account.

Mortality rates among women increased by 0.1% while mortality rates among men continued to decrease by 0.3%.

“Mortality rates fell slightly for males but rose slightly for females in 2018. This is likely to close the gap in life expectancy between the two,” said ONS statistician Beth Humberstone, head of analysis and life events.

“We’re continuing to see the levelling off of mortality improvements and will understand more as we analyse this data further,” she added.

The North East was the region with the highest mortality rates while London had the lowest rates for both men and women.