From 2005 onwards, CEMACH hopes to continue to expand and improve the reporting of perinatal mortality data in order to provide a more comprehensive picture of the factors associated with perinatal deaths in England, Wales and Northern Ireland.
Numbers and rates of `preventable' stillbirths and neonatal deaths
The International Federation of Gynecology and Obstetrics (FIGO) advocates the presentation of perinatal mortality data of infants weighing 1000g or more only to allow international comparisons. Together with the presentation of data showing the relative contribution to mortality of congenital anomaly this classification allows the reporting of a notional `preventable mortality'. This will be reported from 2005 onwards.
Maternal height and weight
From January 2005 onwards, CEMACH has collected information on maternal height, weight and/or BMI. CEMACH therefore hopes to report the association between maternal BMI and stillbirth rate and neonatal mortality rate in its next annual report.
Gestation specific birth weight centiles
From January 2005 onwards, CEMACH has collected adequate information to allow the application of appropriate gestation-specific birth weight centiles to stillbirths and neonatal deaths. This will enable us to estimate the number of deaths that are of babies who are small for gestational age. This, coupled with a further question on evidence of fetal growth restriction, will allow some exploration of the association between growth restriction and stillbirth and neonatal death at a national level.
Gestation at which death was confirmed
In January 2005, guidance issued by the Royal College of Obstetricians and Gynaecologists recommended that if a fetus had died prior to 24 completed weeks of pregnancy but had not delivered until after 24 completed weeks of pregnancy that fetus need not be registered as a stillbirth.10 CEMACH has continued to collect information on all babies delivering after 24 completed weeks of pregnancy showing no signs of life but also asks specific details about the known gestation of death. CEMACH will therefore endeavour to produce statistics based on gestation at delivery and gestation at death in order to try to enumerate the potential change this guidance may have on registration statistics.
Trust-specific data on transferred cases
During 2005, CEMACH resumed collection of `intended place of delivery at booking'. This will enable CEMACH to provide more robust data on the numbers of stillbirths and neonatal deaths that were transferred into trusts to take some account of transfer rates as a component of perinatal mortality. This will form part of the reporting of trust-specific data that are provided as an insert to this national report.