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Friday, 24 October 2014

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Infant death rates in Cumbria continue to decline

Low infant mortality and stillbirth rates in Cumbria have been praised by health professionals – but one in three could potentially have been avoided.

A new report, one of the most detailed of its kind, found that the number of perinatal deaths in the county had consistently fallen over the past five years – and were below both the national and regional average.

The first phase of the report, by analysts at Liverpool John Moores University, involved a review of five years’ worth of statistical evidence.

It found that not only were Cumbria’s figures lower than north west averages, they were also lower than comparable areas such as Devon and Yorkshire.

However, a study carried out in the second phase of the report found that almost one-third of deaths could potentially have been avoided.

Experts looked at 60 perinatal deaths between 2009 and 2010 and reviewed the case notes at random.

They found that one-third of deaths – 0.2 per cent of all the babies born during that year – were potentially avoidable, if care, advice and support had been improved.

In particular, the panel recommended that more must be done to assess women at the start of their pregnancy for any risks which may affect mother or baby’s health.

Professor John Ashton, Cumbria medical director, said: “The number of babies in Cumbria who die shortly before or soon after birth is a tiny proportion of 5,000 births which take place in the county each year.

“Despite that, the sadness and tragedy for those who have lost their child remains very real.

“There are examples where, in the panel’s view, the outcome could potentially have been different if the care, advice and support provided had been better.

“In Cumbria, we spend more on maternity services than other areas and we have more midwives and doctors. We need to make sure that this resource for safe childbirth is being put always to best use.”

He said that the report also found that Cumbria’s results – in terms of potentially avoidable deaths – was broadly in line with national statistics, something Prof Ashton believes may suggests the issue needs to be addressed by the Government.

“The common themes found in Cumbria suggest that the way we approach maternity care as a nation may need to be looked at afresh,” he continued.

“Despite the established systems in place to improve the training, oversight and delivery of maternity care, the report finds that the level of avoidable factors is consistent with those found in national and international studies.”

Prof Ashton said the rural character of Cumbria and the associated distance people are expected to travel for treatment will always be “a thorny problem”.

However, he insisted that innovative models where obstetricians and professionals work across a network of hospitals, coupled with enhanced community-based midwifery services, could help address this.

“The challenge for the future is to develop models of obstetric care that can get the best possible outcomes for our rural population,” Prof Ashton added.

The research found a strong link in Cumbria between lifestyle issues and unsuccessful pregnancies. One in five mothers included in the study had a BMI (body mass index) of 35 of more – a rate at which a person is classified as obese – compared with 10 per nationally. One third also admitted to smoking during pregnancy, compared to one in six in England.

The report will be available to organisations involved in the development of maternity care, alongside Cumbrian hospital trusts and GP commissioners.

Cumbria’s public health team commissioned the report to inform future decisions about the delivery and make-up of maternity services in Cumbria and examine where improvements to services can be made.

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