28 Jun 2016 | Perinatal & Maternal Mortality Review Committee
The Perinatal and Mortality Review Committee’s (PMMRC’s) 10th report, released today, shows a drop in maternal deaths. The Committee advises the Health Quality & Safety Commission on how to reduce these deaths.
In 2014 there were four maternal deaths, the lowest number since the PMMRC began reporting in 2006. The rate of maternal mortality has not changed significantly since 2006 when the data was first reported.
The report also identifies the significant reduction in the number of stillbirth persists.
'It is very pleasing that the stillbirth rate reduced between 2007 to 2014,' says PMMRC chair Dr Sue Belgrave.
'There are a number of reasons for the falling number of stillbirths, including improved care before and after birth and lower smoking rates. Both are encouraging trends.'
The number of babies diagnosed with neonatal encephalopathy reported to PMMRC was the lowest since we began reporting this in 2010. While this is reassuring it is not statistically significant.
Amniotic fluid embolism (AFE) was highlighted in last year’s report, as New Zealand had a higher rate than the United Kingdom. A review of AFE in New Zealand is included in this year’s report, suggesting improvements in the recognition and resuscitation of mothers with amniotic fluid embolism may improve the chance of survival for some mothers.
'AFE is an unpredictable, rare, and often rapidly fatal complication of pregnancy,' says Dr Belgrave.
'We are repeating our recommendation that clinicians involved in the care of pregnant women undertake regular multidisciplinary training in the management of obstetric emergencies. This will improve both the recognition of AFE and resuscitation of women who collapse and potentially prevent some AFE deaths in New Zealand.'
Maternal mortality is more common amongst mothers aged 40 years of age and older, and amongst Māori and Pacific women. Maternal mortality also increases with higher levels of socioeconomic deprivation.
This year’s report includes a special chapter on maternal suicide. It found many women who completed suicide had two or more risk factors for major depression, two thirds had a prior psychiatric history, and most were experiencing relationship stress.
In some cases the PMMRC identified there had been a lack of recognition of risk factors and that communication between health care services could have been better.
'The loss of any life is a tragedy. In the cases of maternal suicide reviewed by the PMMRC, there were instances where services involved in care may have been able to help. It is imperative clinicians work together to prevent the consistent leading cause of death among new and expectant mothers.'
The PMMRC emphasises the importance of all clinicians involved in a woman’s care having knowledge of her mental health history, so they are able to provide the best care. The PMMRC has also recommended a perinatal and infant mental health network be established to provide a forum to discuss perinatal mental health issues.