I have pleasure in introducing this year’s All Wales Perinatal Survey. Since 1993 health practitioners and service managers have been able to access a detailed surveillance report of stillbirth, neonatal and infant mortality in Wales. Analysis of the data presented in the annual survey assists in developing greater understanding of the factors that increase the risk of death in late foetal life and infancy, with the anticipation this will lead to improved outcomes. Unfortunately, as the reports over successive years have shown there remain many unknowns in relation to perinatal deaths. The 2015 data, set out in this report, indicate the cause of perinatal death was unknown in 44% and was missing in 6% of cases, in other words the cause of half of the deaths recorded remains a mystery.

Following the one day inquiry on stillbirth conducted by the National Assembly for Wales (report published in February 2013), a national stillbirth working group was established to coordinate improvement work in NHS Wales. Page 25 sets out the range of activities being undertaken by the national group. The data from this annual survey assists the work of this group in understanding where to focus its attention. The work of the national stillbirth group was only at an early stage when this survey was conducted but it is hoped that in future years the outputs from this work will lead to significant changes in perinatal mortality. Having said this, it is pleasing to note that the stillbirth rate in 2015 was lower than the previous year, standing at a rate 4.12 per 1000 live births (excluding late terminations) compared to 4.64 in 2014.

It is well understood that social deprivation is a key factor in stillbirth and neonatal mortality rates, leading to a significant gap in outcomes between the least and most deprived communities. Just over 25% of mothers in Wales live in the most deprived communities. The five year rolling rates for stillbirth reported here still shows this inequality of outcome, however, the gap is the smallest it has been in more than a decade. Similarly the neonatal mortality rate shows a steady downward trend but still with a marked social divide. While the narrowing of the gap is welcomed it shows there is much more to be done with the most deprived sections of the Welsh population.

The data in this survey is presented geographically by health board and hospital. It was reassuring to note that there are no significant differences in outcome for the different parts of Wales.

I would like to thank the researchers who have again the year produced this excellent resource. I warmly recommend this report to readers and encourage those involved in maternity and neonatal care services to look at the detail provided to help aid understanding on how to make improvements in outcome.

Professor Jean White

Chief Nursing Officer (Wales)

Chair of national stillbirth working group.