Perinatal data collection

This page contains information about how perinatal deaths are identified, and how MBRRACE-UK collects these data.

Identification of perinatal deaths

MBRRACE-UK records and collects information on all eligible perinatal deaths including late fetal losses, stillbirths and neontal deaths.

The eligibility criteria for notification to MBRRACE-UK is based on the baby's gestational age at birth. This means that babies born from 22 completed weeks' gestational age showing no signs of life must be reported to MBRRACE-UK regardless of when the death occurred.

We collect limited information about terminations of pregnancy in order to exclude these cases from MBRRACE-UK reported statistics on perinatal mortality.

Each eligible death should be reported to MBRRACE-UK using a secure online reporting system, which is accessible to UK trusts and health boards that provide maternity and neonatal care. Each trusts or health board where a baby dies is responsible for reporting the death and ensuring data quality and completeness and each has a small number of MBRRACE-UK lead reporters who act as the main points of contact.

To identify any eligible deaths that have not been reported directly to MBRRACE-UK, details of registered deaths are also obtained from national death registries.

Identification and reporting of perinatal deaths in England with the new Cascade integrated process

In response to requests from Trusts in England to reduce the amount of duplicate reporting of perinatal deaths, a new process for notifying neonatal deaths to Child Death Overview Panels (CDOPs) has been developed, called Cascade. As is currently the case, information from CDOPs will then flow to the National Child Mortality Database (NCMD).

Cascade combines the notification of neonatal deaths to MBRRACE-UK and CDOPs into a single step.

Cascade will be launched on 8th January 2025 and the new process will apply in England from this date.

Guidance for Trusts in England about Cascade is available to download.

Guidance for CDOPs about Cascade is available on the NCMD website.

Collecting surveillance information in England, Scotland and Wales

For each perinatal death that is reported, MBRRACE-UK collects information about the mother and her baby. This includes:

• mother's and baby's identifying information;
• mother's health, lifestyle and previous pregnancy history;
• mother's antenatal care;
• labour and delivery;
• cause of death and post-mortem examination

For more detailed information about the identification, reporting and statistical methods used to analyse perinatal deaths, please see the MBRRACE-UK perinatal mortality surveillance technical manual.

Calculating and reporting perinatal mortality rates

The MBRRACE-UK perinatal mortality surveillance technical manual contains full details of the statistical methods used to calculate the mortality rates.

To reduce variability and allow for comparability between organisations, most perinatal mortality rates calculated by MBRRACE-UK do not include babies born at less than 24 completed weeks' gestational age and all terminations of pregnancy are excluded.

National perinatal mortality rates including rates of stillbirths, neonatal deaths and extended perinatal deaths are presented for babies born from January 1 to December 31 each year. This means that babies born in December of one year and who die in January of the next year are included in the previous year's report. This method of reporting is in contrast to other publications, which are based on deaths which occurred or were registered in a calendar year. This “birth cohort” approach allows for a more accurate estimate of mortality rates as appropriate denominator data are available.

Alongside national perinatal mortality rates, perinatal mortality rates are also reported for each devolved nation, region, commissioning organisation and Trusts/Health Boards. These rates can be viewed using the MBRRACE-UK data viewer. As the numbers of perinatal deaths can be very small for some individual organisations, numbers and some rates are suppressed when there are fewer than three deaths in a year. This is to preserve anonymity and confidentiality.

All eligible deaths occurring in a calendar year in the UK, including deaths due to congenital anomalies, are analysed by MBRRACE-UK and presented as national perinatal mortality rates in an annual “State of the Nation” report.

Collecting information for perinatal confidential enquiries

For perinatal confidential enquiries, the MBRRACE-UK team requests copies of medical records from local trusts/health boards involved in the care of the selected mothers and babies. All records are fully anonymised before being uploaded to a secure online platform for review by expert as part of the confidential enquiry process. For babies who died in Northern Ireland, anonymised notes are supplied by Northern Ireland Maternal and Child Health (NIMACH).

Identifying and collecting information about perinatal deaths in Northern Ireland

Privacy arrangements in Northern Ireland restrict identifiable information from being transferred out of the province. Because of this, all eligible perinatal deaths are first reported to the Northern Ireland Maternal and Child Health (NIMACH) office of the Public Health Agency of Northern Ireland. Anonymised information about each death is then reported to MBRRACE-UK by the NIMACH office.