Understanding perinatal mortality

The term perinatal death is used to describe antepartum and intrapartum stillbirths, and early neonatal deaths. Although the overall rate of perinatal mortality is falling, a slower rate of reduction has been observed in stillbirth compared to neonatal death. Antenatal stillbirth contributes to a greater proportion of cases in high income countries and associated risk factors include maternal age, smoking, obesity and small for gestational age fetus. At term, intrapartum stillbirth and neonatal death are collectively referred to as delivery related perinatal death, and the incidence in nulliparous and multiparous women is approximately 1 in 1000 and 1 in 2000 births, respectively. Associated factors include advanced maternal age, small for gestational age, fetal macrosomia, breech labour and previous caesarean delivery. The impact of obstetric interventions in labour on delivery related perinatal death, including rising rates of caesarean delivery, is complex and unclear.