Infant Mortality

The local picture

Child Health Profiles show that in 2013-2015 Central Bedfordshire had a statistically lower percentage of infant deaths compared to the England average (2.0% against 3.9%) and lower compared with the East of England Average (3.4%). Central Bedfordshire has the lowest infant mortality rate in both the East of England and its deprivation decile (least deprived decile) and the second lowest infant mortality rate in the country for this period.

Table 2 shows the crude stillbirth, perinatal, neonatal death and infant mortality for Central Bedfordshire in 2010-15 (pooled).  For infant mortality, Central Bedfordshire has a lower rate than both East of England and England, though not significantly.

Rate per 1,000 (95% CI)
Table 2: Stillbirth, perinatal death, neonatal death & infant mortality rates for Central Bedfordshire, East of England and England, 2012-14 (average). Source: Health & Social Care Information Centre *Confidence intervals
  Stillbirth Perinatal Neonatal Infant mortality
Central Bedfordshire

3.4

(2.4 - 4.7)

5.4

(4.1 - 7.1)

2.4

(1.6 - 3.5)

3.1

(2.2 - 4.4)

East of England

4.1

(3.8 - 4.3)

6.1

(5.8 - 6.4)

2.6

(2.4 - 2.8)

3.6

(3.4 - 3.9)

England

4.7

(4.6 - 4.8)

6.8

(6.7 - 6.9)

2.8

(2.7 - 2.8)

4.0

(3.9 - 4.1)

The following graph shows the decline in mortality rates over a 10 year period indicating that measures to prevent infant deaths are having some impact both nationally and locally.

Rates of deaths at undr 1 year old per 1,000 births, 2004-2015

Rates of deaths at under 1 year old per 1,000 births, 2004-2015. Source: Health & Social Care Information Centre & Child Health Profile

The spike shown by the graph in Central Bedfordshire’s infant mortality in 2011-2013 can be attributed to the small numbers of actual deaths in a relatively small population which can result in apparently large fluctuations even using averages over three years.

It can be seen that Central Bedfordshire has in recent years continued to see a decrease in the rate of infant mortality, in line with both the East of England and England. Between 1st April 2013 and 31st March 2014 46 children died across Bedfordshire and Luton (CDOP Annual report 2014) of whom 61% (28/46) were infants (children less than 1 year of age), with 10% of these deaths recorded as Sudden Unexpected Deaths in Infancy.

Overall, the childhood mortality rate has reduced by 30% in 2012-14 compared to 2011`-2013 with the most significant reduction in the number of deaths reported in the 0-28 day age range where there has been a 50% reduction in the number of deaths.

Rates of still births and deaths at under 7 days per 1,000 births, 2004-2014

Rates of still births and deaths at under 7 days per 1,000 births, 2004-2014. Source: Health & Social Care Information Centre

In recent years, Central Bedfordshire has also seen a decline in perinatal mortality; a decline that has brought the rate lower than the East of England and significantly lower than England.

Risk Factors

Maternal age

When considering risk factors for stillbirth, older mothers in Central Bedfordshire (aged 40+ years at delivery) had the highest stillbirth rate per 1,000 live births compared to other maternal age groups. (Local data unavailable for the 11-15 year age range). For 2012-2014 there were no stillbirths from mothers aged under 20 recorded. This is fewer than the East of England and England rate.

Rate of stillbirths per 1,000 births, 2014-2014 rolling average.

Rate of stillbirths per 1,000 births, 2014-2014 rolling average. Source: Health & Social Care Information Centre

Smoking and excess weight

The link between infant mortality and maternal excess weight and smoking at the time of delivery is clear vii. From 01/01/2015 to 31/12/2016 the number of women booking a pregnancy at the Luton and Dunstable Hospital from Central Beds CCG, with a BMI of ≥30, was 295 (data obtained from hospital data recording system).

Data for Bedfordshire CCG for 2015/16 show that 10.3% of maternities smoke at the time of delivery. This is set against an aspirational target of 11%. However the Luton and Dunstable hospital data (2015/16)for Central Bedfordshire women show that 19.9% (255 women) were smokers at the time of delivery. 2015/16 Child health data (2015/16) shows that for Central Bedfordshire, the smoking at time of delivery percentage is 10.3% as compared to the England average of 10.6%.

The Child Death Overview Panel reports on Modifiable factors contributing oi an infant death. These factors include smoking, raised maternal body mass index, unsafe sleeping practices, consanguinity and factors related to service provision.

In 2014 – 2015 modifiable factors were identified in 40% of cases, which is higher than the national picture in 2013 -2014 of 22%.

Deprivation

 

Total number of childhood deaths

0-19 yr

Proportion of childhood deaths that were infants

aged under 1

Comparison of childhood deaths in the most deprived and least deprived wards. Source: PHI Central Bedfordshire
20% most deprived wards (6 wards) 8 28%
80% least deprived wards (25 wards) 33 48%

The data detailed in the table above do not show a correlation between deprivation and the number of infant deaths across Central Bedfordshire between 2013 and 2015.

 

 


Last updated Thursday, 11th May 2017