Babies in Midlands and North ‘more likely to die around birth’

Babies in the Midlands and the north of England are more likely to die before, during or shortly after birth than those in the south, according to a new study.

Researchers analyzed data from 121 maternity services in England to see which centers repeatedly produced better or worse results than average between 2013 and 2022.

The 10 worst performing centers were in the Midlands and the north of England, and the 15 best performing centers were in the south.

A review of maternity care is underway, with Health Secretary Wes Streeting saying “systemic failures causing preventable tragedies cannot be ignored”.

The study, carried out by researchers at the University of Calgary and published in the Journal of Public Health, was based on death surveillance reports from MBRRACE-UK, which examines late fetal losses, stillbirths and neonatal deaths in the United Kingdom.

It found that three of the 121 trusts reporting figures – Sandwell and West Birmingham Hospitals NHS Trust, Leeds Teaching Hospitals NHS Trust and Royal Devon University Healthcare NHS Foundation Trust – had a higher than average mortality rate in each of the 10 years examined, compared to services of comparable size.

Shrewsbury and Telford Hospital NHS Trust, which is currently the subject of an ongoing police investigation, recorded worse than average rates in nine of the ten years.

In comparison, three trusts had lower than average mortality rates in each of the 10 years analyzed: Norfolk and Norwich University Hospitals NHS Foundation Trust, Royal Free London NHS Foundation Trust and University College London Hospitals NHS Foundation Trust.

Data were adjusted for factors known to affect mortality rates, including socioeconomic deprivation, ethnicity and gestational age at birth.

MBRRACE-UK has been producing data for 10 years, with its reports ordering the worst-performing maternity services to carry out a review or investigation to identify factors that could be responsible for their comparatively higher mortality rates.

But the study authors say they found no evidence that if changes were made they would have an impact.

They hope this latest study will provide lessons by allowing these services to visit and observe “the policies, culture and clinical practices of those who report consistently lower than average or declining mortality rates”.

In total, the study found there were 33,943 perinatal deaths in England between 2013 and 2022. These included 10,478 neonatal deaths, occurring in the first 28 days of life, and 23,465 stillbirths.

In 2015, the then Conservative government announced its ambition to halve the rate of stillbirths, neonatal and maternal deaths in England by 2030 – then brought forward to 2025.

The report’s authors said that target had not been met, but that a 36% reduction in stillbirths and neonatal deaths over that period – to 4.84 per 1,000 total births – was still “significant”.

A review of maternity care in England, led by Baroness Amos, will be published in the spring.

Releasing an interim report in December, she said what she had seen so far “has been much worse” than she had expected.