11 - Conditions of the perinatal period

Summary

‘Perinatal’ refers to conditions of the newborn, more specifically, the deaths of babies from the seventh month of pregnancy until the baby is a week old. This is a residual category of the broader category ‘perinatal conditions’. For the death rates here, the conditions start in the perinatal period but the actual deaths can occur after the perinatal period (reflected in the average age of death).

From the most privileged neighbourhoods of the Home Counties to the worst-off northern inner cities and almost all of Scotland, an infant’s chances of dying from these conditions varies more than tenfold. All of the neighbourhoods with SMRs of 200 or above are in Scotland, apart from the Birmingham neighbourhood of West Bromwich Central. These deaths do not include sudden death, cause unknown, or deaths from congenital defects.

A quarter of these deaths are a result of low birthweight. A birthweight below 2,500g (5lb 8oz) is considered to be low. Low birthweight may be due to the baby being born early (prematurity) or the baby may be growth retarded (small for the period it has been in the womb). Causes and associations include illnesses in the mother, her smoking, her poverty and her malnutrition. Multiple pregnancies (twins etc) also cause lower birthweight. The lower the birthweight, the higher the need for skilled medical help for the baby to survive. Low birthweight can cause cerebral palsy where there is paralysis affecting the use of arms, legs and the muscles used in speech. Low birthweight caused 2.22% of all deaths worldwide in 2002. In Britain it is responsible for a proportion 100 times smaller.

Over half of these deaths are due to trauma around the time of birth or shortly after, such as asphyxia and other respiratory distress. Before birth, a baby receives oxygen from its mother’s placenta via the blood in the umbilical cord. After birth it gets oxygen from its own lungs by breathing. Difficulties during labour can cause a delay between the first stopping and the second starting. The baby then becomes short of oxygen (birth asphyxia), which can be immediately fatal. Birth trauma refers to injuries to the baby that occur during the process of birth.