the 2010 pmmrc report: an overview
DESCRIPTION
The 2010 PMMRC Report: an overview. Perinatal Mortality 2007-2010 Maternal Mortality 2006-2010. Methodology. Definitions. Perinatal related mortality rate - /1,000 Maternal mortality ratio - /100,000 Ethnicity – prioritised maternal DHB of maternal residence at birth registration - PowerPoint PPT PresentationTRANSCRIPT
Methodology
Perinatal Maternal
Definition of cases > 20 wks< 28 days
Direct, indirect to 6wks (Co-incidental)
Ascertainment of cases Clinicians; LMCs; Local coordinatorsBDM; NMDS; Coroners; media
Data sources LMCs; hospitals; GPs; Coroners; Police
Review of cases, classification of cause, contributory factors, and potentially avoidable death
Localmultidisciplinary
Nationalmultidisciplinary
Denominator data Registered births - BDM
Definitions
• Perinatal related mortality rate - /1,000• Maternal mortality ratio - /100,000• Ethnicity – prioritised maternal• DHB of maternal residence at birth registration• Deprivation quintile (NZDep 2006)• Contributory factors - including organisation and
management, personnel, equipment and technology, environment, and barriers to access/engagement factors that contributed to the death
• Potentially avoidable death – defined when the absence of a factor may have prevented the death
Perinatal related mortality NZ and UK 2007-2010
0
2
4
6
8
10
2007 2008 2009 2010
Peri
nata
l mor
talit
y (p
er 1
000)
NZ (CMACE defn) perinatal mortality UK perinatal mortality
Perinatal related mortality NZ and Australia 2007-2010
*excludes Victoria
0
2
4
6
8
10
12
2007 2008 2009 2010
Mor
talit
y ra
te (p
er 1
000)
NZ Perinatal related mortality Australia Perinatal related mortality
*excludes Victoria
Ethnicity and deprivation quintile standardised perinatal related mortality CMDHB 2007-2010
CMDHB NZ
Crude 13.1 10.8
Adjusted 10.9 10.5
Smoking, drug and alcohol use among mothers of babies who
died 2010
• Smoking 29%• Alcohol at least 8.8%• Marijuanaat least 3.4%
*16% missing data
• Other drugs <1%
Among perinatal deaths, alcohol and marijuana were associated with death from spontaneous preterm birth and SUDI
Maternal mortality 2006-2010
• Contributory factors 53% of maternal deaths– Organisation and management 32%– Personnel 30%– Barriers 37%
• Potentially avoidable 32% of maternal deaths
• CMACE 2006-2008 61% substandard care; 36% significantly contributing to death
Recommendations 2010:perinatal mortality
• Timely delivery is recommended for confirmed SGA at term
• Women should be given guidelines for ideal maternal gestational weight gain
• Smoking cessation advice is the responsibility of all health professionals
Recommendations 2010:Maternal mortality
• Identifying women with medical problems and referring early
• Support for the Health Beginnings report on maternal and perinatal mental health services in NZ, in particular
• A mother and baby unit should be established in the Auckland region
• Composition of comprehensive mental health services
• MMH screening in termination of pregnancy services