Eleventh Annual Report of the Perinatal and Maternal Mortality Review Committee

This report considers perinatal and maternal mortality and morbidity from 1 January to 31 December 2015; perinatal mortality from 2007 to 2015; maternal mortality from 2006 to 2015; and babies with neonatal encephalopathy from 2010 to 2015.

In this report the PMMRC have also introduced data and discussion related to Maori. We need to focus our lens on outcomes for Māori mothers and infants, as the inequity between Maori and non-Māori continues.

The outlying causes of stillbirth and neonatal death among babies of Māori mothers are spontaneous preterm birth, antepartum haemorrhage, maternal conditions (mostly diabetes-related), and hypertension.

There is a significantly higher, almost double, maternal mortality ratio among Māori mothers than New Zealand European mothers. Tragically, Māori women are over-represented among maternal suicides. The main contributory factors amongst these deaths continue to be barriers to access and/or engagement with care, which the PMMRC will be working with the sector to improve.

Also new to the PMMRC report is the work of the Maternal Morbidity Working Group (MMWG). In May 2016 we welcomed this working group dedicated to reducing maternal morbidity to the PMMRC. The MMWG transitioned to the Commission from the existing Severe Acute Maternal Morbidity (SAMM) research group based at the University of Otago. Supported and funded by the Ministry of Health, the group will be active through to June 2019. The MMWG is responsible for nationally reviewing incidences of women who are pregnant or have recently delivered who are also very ill, and developing quality improvement initiatives alongside the maternal health services. This group is supporting the work of the PMMRC to improve the quality and experience of maternity care for women, babies and wha¯nau, informed by robust, consistent, reportable and women-centred maternal morbidity review.

The perinatal related mortality rate in 2015 is the lowest reported since the PMMRC began collecting data in 2007 and is significantly lower than the rate for the years 2007–2014 combined. We are pleased to report a statistically significant reduction in fetal deaths (stillbirths and late terminations of pregnancy combined) from 2007 to 2015, and an ongoing statistically significant reduction in stillbirths. The neonatal death rate has not changed significantly in New Zealand from 2007 to 2015, and note that the PMMRC have indicated that this will be a key are of investigation for 2017–2018. There have been significant reductions in neonatal mortality in the United Kingdom (UK), Australia and Scandinavia, and we will look to learn from those experiences.