The Contribution of Newborn Health to Child Mortality across England

This report draws on data from the National Child Mortality Database (NCMD) to investigate how illness around the time of birth affects the health of children up to the age of 10, and to draw out learning and recommendations for service providers and policymakers.

When a child dies, at any age, the cause of their death may have originated in an event that occurred in, or around, the time that they were born. It may be that they were born prematurely (before 37 weeks gestation), suffered an injury during or shortly after birth, or suffered a perinatal infection. This report aims to understand patterns and trends in child deaths where an event before, or around, the time of birth had a significant impact on life, and the risk of dying in childhood. 

This report – the third such thematic report from the NCMD – also includes analysis of the modifiable factors (those factors that, had they been different, may have prevented the child from dying) identified in the review of these children’s deaths by Child Death Overview Panels (CDOPs). 

Key findings in brief

• From a public health perspective, it is possible that neonatal illness contributes to 72% of all deaths under 10 years of age. 
• Children who received additional care after birth (neonatal care) made up 83% of children who died before their 1st birthday, 38% of deaths in the next 4 years, and 27% of deaths between the ages of 5 and 9.  
• For babies born alive, at or after 22 weeks gestation, who subsequently died before 10 years of age between 1 April 2019 and 31 March 2021, half of the deaths occurred in children over one month old. 
• There is a clear association between childhood death following neonatal illness and learning disabilities. Over half of the children who died also had learning disabilities.  
• Where deaths were found to be caused by a perinatal event, the majority (78%) were caused by prematurity-related conditions. 13% were caused by perinatal asphyxia, 4% were caused by a perinatally acquired infection, and 4% were due to other causes.  
• Modifiable factors were identified in 34% of the deaths reviewed. The most common were smoking in pregnancy, lack of involvement of appropriate services, and maternal obesity.