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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
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The 2010 PMMRC Report: an overview Perinatal Mortality 2007-2010 Maternal Mortality 2006-2010
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 Australia 2007-2010 *excludes Victoria *excludes Victoria
Perinatal Death Classification (PDC) among all perinatal related deaths 2007-2010 Figure 16 pg 31
NDC among neonatal deaths (excluding FA) by gestation 2007-2010 Figure 18 pg 35
Ethnic specific perinatal related mortality 2007-2010 Figure 22 pg 42
Ethnic specific neonatal death rate by gestation group 2007-2010 Figure 19 pg 36
PDC specific perinatal related mortality rate by ethnicity 2007-2010 Figure 24 pg 45
Age specific perinatal related mortality 2007-2010 Figure 20 pg 39
PDC specific perinatal related death rates by age 2007-2010 Figure 21 pg 40
Deprivation quintile specific perinatal related mortality 2007-2010 Figure 26 pg 47
DHB of residence and perinatal related mortality 2007-2010 Figure 28 pg 49
DHB of residence and Ethnicity 2010 Figure 13 pg 25
DHB of residence and Deprivation Quintile 2010 Figure 14 pg 26
Ethnicity and deprivation quintile standardised perinatal related mortality CMDHB 2007-2010
Smoking, drug and alcohol use among mothers of babies who died 2010 • Smoking 29% • Alcohol at least 8.8% • Marijuana at 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
Contributory factors and potentially avoidable perinatal related deaths 2010 Figure 33 pg 67
Contributory factors by ethnicity among perinatal related deaths ’09-’10 Figure 32 pg 72
Contributory factors by cause of perinatal related death ’09-’10 Figure 29 pg 70
Maternal mortality: ‘06-’10 Figure 35 pg 77
Maternal mortality: international data 2006-2008 UK 11.4/100,000 2006-2008 NZ 18.3/100,000
Maternal mortality and maternal age 2006-2010 Figure 33 pg 80
Maternal mortality and maternal ethnicity 2006-2010 Figure 34 pg 80
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