Section B: Mortality Statistics in Wales – Post Neonatal

  1. Post neonatal mortality in Wales (deaths from 28 days to 1 year of age)
  2. Causes of post neonatal deaths
  3. References

We have previously reported infant mortality rates in the same year as that of the report. However, deaths can occur up to the end of the year in which the report was published. Thus, from 2013, we have started reporting infant mortality rates for the previous calendar year. The post neonatal mortality rate to women usually resident in Wales in 2014 was 0.86 per 1,000 births, which is lower than the 2013 rate (1.3 per 1,000 births in 2013). However, the 3 year rolling average rates presented in Figure 16 are similar in recent years (Table A12).

Figure 16: Post neonatal deaths (excluding late terminations): 3 year rolling average in Wales (1994-1996 to 2012-2014)
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Between Health Boards, the post neonatal mortality rate in 2014 ranged from 0.00 per 1,000 livebirths (95% CI 0, 3.42) in Powys Teaching University Health Board, to 1.55 per 1,000 livebirths in Cardiff and Vale University Health Board (95% CI 0.82, 2.94) (Table A12). The funnel plot (Figure 17) compares post neonatal mortality rates between Health Boards over the 5-year period 2010 to 2014. The majority have post neonatal mortality rates that lie within the 95% confidence limits of the funnel plot, although the rate for Powys Teaching Health Board was significantly below the average, and lies outside the lower 95% confidence limit. These rates are not adjusted for case mix or socio-demographic characteristics, which may explain some of the observed variation, and due to small numbers these should be treated with caution.

Figure 17: Post neonatal mortality rate (excluding late terminations by Health Board to mothers resident in Wales: 2010-2014
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Figure 18: Post neonatal mortality rate by deprivation quintile: five year rolling rates (1994-1998 to 2010-2014)
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Figure 18 shows the post neonatal death rates for the deprivation quintiles of the population as given by the Welsh Index of Multiple Deprivation (WIMD). Cases were allocated to the appropriate quintile of deprivation based on mother’s residence and LSOA. Within Wales, post neonatal death rates are higher in the most deprived quintile of social deprivation compared to the least deprived quintile; however, the gap has narrowed since 2000 (Figure 18). Sudden Infant Deaths (SIDs), specific conditions, accidental death and infection were causes of death that were strongly associated with deprivation. The greatest effect of deprivation on infant mortality is in the post neonatal period1, 2. SIDs was the focus of a joint report between AWPS and CDR published in January 2015. A copy of the report can be obtained from the AWPS website.

Causes of post neonatal deaths

This year, we report post neonatal deaths for infants born in 2014. We present data on causes of death for post neonatal deaths using the CODAC classification (Figure 19). In 17% of post neonatal deaths, the cause of death was unknown and in 41% of cases the cause was missing.

Figure 19 Single main cause of post neonatal deaths using CODAC classification: 2014
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1.         Guildea ZE, Fone DL, Dunstan FD, Sibert JR, Cartlidge PH. Social deprivation and the causes of stillbirth and infant mortality. Archives of Disease in Childhood 2001;84(4):307-10

2.         Oakley L, Maconochie N, Doyle P, Dattani N, Moser K. Multivariate analysis of infant death in England and Wales in 2005-06, with focus on socio-economic status and deprivation. Health statistics quarterly / Office for National Statistics 2009(42):22-39