Perinatal and Maternal Mortality in 2009

28 Jul 2011 | Perinatal & Maternal Mortality Review Committee

The Perinatal and Maternal Mortality Review Committee (PMMRC) has published its fifth annual report on the deaths of babies and their mothers in New Zealand.

PMMRC advises the Health Quality & Safety Commission on how to reduce these deaths.

The PMMRC report shows that perinatal mortality rates in 2009 were comparable with rates in Australia and the United Kingdom but also highlights the increased risks of stillbirth facing mothers who are young, poor, or Maori or Pacific.  

“For the first time we are reporting that a number of perinatal deaths were potentially avoidable,” says PMMRC Chair, Professor Cynthia Farquhar. “Of all perinatal deaths 14 percent were thought to be potentially avoidable.  That amounts to 98 lives that could have potentially been saved.

“We can also see that some groups of women and babies are particularly at risk – for example, teenage mothers – and more needs to be done to meet their specific needs during pregnancy and the period immediately afterwards.”

Professor Farquhar says New Zealand has very good maternity services but there is always room for improvement.

“This report aims to identify what maternity and neonatal services should focus on if we want to reduce perinatal and maternal deaths.”

Key findings of the report include:

  • In 2009 the perinatal related mortality rate was 11.3 per 1000 births, comparable with rates in Australia and the United Kingdom.
  • Teenage mothers (aged under 20) are at higher risk of stillbirth and neonatal death than mothers aged 20 to 39.
  • The stillbirth rate in 2009 was 6.3 per 1000 births.  One quarter of stillbirths continue to be unexplained, and half of these occur at term.
  • Maori and Pacific mothers are more likely to have stillbirths and neonatal deaths than New Zealand European and non-Indian Asian mothers.
  • The maternal mortality rate in 2009 was 22 per 100,000 maternities. The 2009 rate was increased by four pandemic influenza A H1N1 maternal deaths in that year.  
  • The most frequent causes of maternal death in New Zealand from 2006 to 2009 were suicide, pre-existing medical conditions, and amniotic fluid embolism.

Professor Farquhar says PMMRC is recommending a number of practical measures which it believes will help reduce the number of deaths of babies and mothers.

For example, it suggests establishing a national intersectoral working group to consider the best way of providing services to young mothers in order to better meet their needs.

It is also recommending measures to improve the recognition of women at increased risk of perinatal mortality, assessment of maternal mental health at the point of first contact with health services, and regular training in managing obstetric emergencies for all staff involved in the care of pregnant women.

Other key findings and recommendations can be found in the PMMRC report, available on the Health Quality & Safety Commission’s website.

“The death of a baby or mother is a tragedy and we need to learn from these deaths to make improvements that will, ultimately, save lives,” says Professor Farquhar.

“I’m confident this report makes a significant contribution to the sector’s understanding of why women and babies die, and PMMRC looks forward to discussing the issues raised here with clinical leaders and health managers.”

Mortality Definitions:

PMMRC reviews maternal deaths and all deaths of infants from 20 weeks gestation to 28 completed days after birth, or weighing at least 400g if gestation is unknown.

A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management.  It does not include accidental or incidental causes of death of a pregnant woman.

Maternities are all live births and all fetal deaths at 20 weeks or beyond, or weighing at least 400g if gestation was unknown.  In 2009 the maternal mortality rate was calculated per 100,000 maternities.

Perinatal mortality is fetal and early neonatal deaths, from 20 weeks gestation until less than seven days of age or weighing at least 400g if gestation was unknown.

The perinatal-related mortality rate is fetal deaths (including terminations of pregnancy and stillbirths) and neonatal deaths (up to 28 days) per 1000 total babies born at 20 weeks or beyond, or weighing at least 400g if gestation is unknown.

Neonatal mortality is all infant deaths from live birth to 27 days of age inclusive.

Last updated 25/05/2012